The spectrum of cranial neuropathy in patients with Bell's palsy.
BACKGROUND
There is controversy regarding whether, and how frequently, other cranial nerve deficits accompany Bell's palsy. We sought to determine prospectively the presence of signs indicating an associated cranial neuropathy in patients with Bell's palsy.


METHODS
All subjects presenting to an emergency department with Bell's palsy over a 2-year period were evaluated. The study included 51 consecutive patients. One patient with Bell's palsy was not examined by a neurologist at the time of presentation and was excluded. The main outcome measure was presence of other cranial nerve deficits.


RESULTS
We identified 4 patients with additional cranial neuropathies (contralateral trigeminal [n=1], glossopharyngeal [n=2], and hypoglossal [n=1]). We also identified 13 patients with ipsilateral facial sensory loss, suggesting an ipsilateral trigeminal neuropathy; 3 patients with a contralateral facial palsy; and 3 patients with hearing impairment.


CONCLUSIONS
This prospective study indicates that a small percentage (approximately 8%) of patients with otherwise typical Bell's palsy may harbor additional cranial neuropathies.
Benatar
Michael
M
Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass., USA. mbenata@emory.edu
Edlow
Jonathan
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020330:Bell Palsy / Q000150:complications*; D003389:Cranial Nerve Diseases / Q000150:complications*; D004401:Dysarthria / Q000209:etiology; D004427:Ear Diseases / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D014786:Vision Disorders / Q000209:etiology