Clinical prognostic factors for treatment outcome in Bell's palsy: a prospective study.
Article
in English
| IMSEAR
| ID: sea-39123
ABSTRACT
OBJECTIVE:
To evaluate the clinical factors for predicting the outcome in Bell's palsy patients treated by oral prednisolone.DESIGN:
Prospective study in a tertiary-care neurological hospital. MATERIAL ANDMETHOD:
Three hundred and eighty cases of acute unilateral lower motor neuron type of facial palsy were enrolled initially from a neurological clinic. After exclusion of the unfulfilled criteria cases, 201 cases of Bell's palsy completed the study protocol and were followed for six months after a seven-day course of 60 mg/day followed by a five-day taper-off dosage of oral prednisolone. A modified House-Brackman facial paralysis grading system was used to evaluate the recovery of facial weakness in the serial follow-up examination. Correlation between demographic data, clinical presenting symptoms and signs, and the final outcome were analyzed by multiple logistic regressions to determine the significant clinical prognostic factors.RESULTS:
There was a significant overall recovery of the facial weakness in succession throughout the 12 weeks of the follow-up period. The mean facial muscle scores approached the level of favorable outcome at the twelfth week after treatment. Duration between onset and treatment longer than seven days (RR = 18.87, 95% CI = 4.97-71.53), severe facial paralysis (RR = 5.01, 95% CI = 2.52-9.95), hearing defect (RR = 3.01, 95% CI = 1.16-7.84), and history of recurrence (RR = 3.75, 95% CI=1.21-11.59) were the significant prognostic factors for unfavorable outcome of treatment (p < 0. 05).CONCLUSION:
Delayed in initiation of oral prednisolone, severe facial weakness, hearing defect, and history of recurrence were significant prognostic factors determining the poor outcome. To yield a satisfactory therapeutic result, early treatment of Bell's palsy with oral prednisolone should be recommended in cases of severe facial paralysis.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Prognosis
/
Recurrence
/
Female
/
Humans
/
Male
/
Prednisolone
/
Logistic Models
/
Risk
/
Prospective Studies
/
Health Status Indicators
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Language:
English
Year:
2008
Type:
Article
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