The Role of Diabetes Mellitus in the Clinical Presentation and Prognosis of Bell Palsy

Background: Bell palsy is considered to be an entrapment neuropathy resulting from inflammation, edema, and strangulation. Diabetes, hypertension, and hypercholesterolemia have all been related to microangiopathies. However, the relationship between the frequency, severity, and recovery course of Bell palsy in patients with these pathologies is a matter of controversy. Methods: Fifty-six patients with Bell palsy were evaluated according to the House-Brackmann grading system a few days after the onset of the disease and 6 months later and correlated to their hypertension, hypercholesterolemia, and diabetes records. Diabetes was evaluated by the use of serum glycosylated hemoglobin (HbA1c). Results: The 20 patients with abnormal HbA1c values were more frequently diagnosed with Bell palsy of grade V/VI (P .008; odds ratio, 4.7; 95% CI, 1.4‐15.2). However, their House-Brackmann scores were not found to be worse at the 6-month follow-up visit (P .9). No correlations were found for hypertension and hypercholesterolemia. Conclusions: A relationship between the severity of Bell palsy and abnormal HbA1c values seems to be demonstrated. However, the prognosis of these patients does not seem to be worse because at the 6-month follow-up visit they present similar scores to nondiabetic patients. (J Am Board Fam Med 2012;25:819‐826.)