Is There a Cranial Nerve Other Than the 7th Co-Involved in Bell's Palsy? Answer to the Systematic Review
Cranial Nerve in Bell's Palsy
Vol. 17 No. 1 : 2022 (44-61)
Abstract
Bell's palsy is characterised by one-sided lower motor neuron impairment of the facial nerve. Even though Bell's palsy is a peripheral facial nerve palsy, other cranial nerves should be investigated, because they are anatomically interconnected rather than isolated. The study aimed to look for evidence of other cranial nerves being involved in Bell's palsy. CINAHL, Academic Search Complete, MEDLINE, SPORTDiscus, and Scopus, all of which were updated until May 2021, were used to conduct a comprehensive search. Bell's palsy research focused on the origins and cause of the condition, regardless of study design, was eligible for inclusion. Animal research, non-English studies, grey literature, studies with no full text available, and those published in non-peer-reviewed journals, were excluded. While 3883 papers were found during the initial search, only 13 were included in the final study. The Joanna Briggs Institute Manual for Evidence Synthesis and Sackett’s standard of evidence was used to assess the validity of the papers that were screened. The most common type was case series (n=5), followed by case-control (n=4), case report (n=3), and cross-sectional (n=1). Most of the articles were categorised as Level-IV (n=8), followed by Level-V (n=3), with only two studies classified as Level-III (n=2) by Sackett’s criteria. The trigeminal and vestibulocochlear nerves are the most involved cranial nerves in Bell's palsy. The optic, oculomotor, trigeminal, vestibulocochlear, glossopharyngeal, vagus, and hypoglossal nerves are the seven cranial nerves potentially associated with Bell's palsy.
Keywords: Bell's palsy, clinical anatomy, cranial nerve, facial nerve, neuroanatomy
Keywords :
Bell's Palsy,
clinical anatomy,
cranial nerve,
facial nerve,
neuroanatomy,
Correspondance Address
Razif Abas. Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Malaysia. Tel: +6013 3946543 Email: razifabas@gmail.com
References
Adour, K.K., Byl, F.M., Hilsinger, R.L. Jr., Kahn, Z.M., Sheldon, M.I. 1978. The true nature of Bell's palsy: analysis of 1,000 consecutive patients. Laryngoscope 88(5): 787-801.
Benatar, M., Edlow, J. 2004. The spectrum of cranial neuropathy in patients with Bell's palsy. Arch Intern Med 164(21): 2383-5.
Brach, J.S., VanSwearingen, J.M. 1999. Not all facial paralysis is Bell's palsy: a case report’. Arch Phys Med Rehabil 80(7): 857-9.
Burns, P.B., Rohrich, R.L., Chung, K.C. 2011. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg 128(1) 305-10.
De Seta, D., Mancini, P., Minni, A., Prosperini, L., De Seta, E., Attanasio, G., Covelli, E., De Carlo, A., Filipo, R. 2014. Bell's palsy: symptoms preceding and accompanying the facial paresis. Scientific World Journal 2014: 801971.
Edstrom, S.P., Harmer, S.P., Rosenhall, U., Andersen, O, Badr, G., Frisen, L., Karlsson, B., Vahlne, A. 1984. Evidence of stem lesions in patients with Bell's palsy. Facial Nerve 224-7.
Esteban, A, Andres, C.De., and S Gimenez-Roldan, 1978. Abnormalities of Bell's phenomenon in amyotrophic lateral sclerosis: a clinical and electrophysiological evaluation. J Neurol Neurosurg Psychiatry, 41: 690-98.
Hanner, P., Badr, G., Rosenhall, U., Edström, D. 1986. Trigeminal dysfunction in patients with Bell's palsy. Acta Otolaryngol 101(3-4) 224-30.
Hanner, P., Andersen, O., Frisén, L., Rosenhall, U., Edström, S. 1987. Clinical observations of effects on central nervous system in patients with acute facial palsy. Arch Otolaryngol Head Neck Surg 113(5): 516-20.
Heckmann, J.G., Urban, P.P., Pitz, S., Guntinas-Lichius, O., Gagyor, I. 2019. The diagnosis and treatment of idiopathic facial paresis (Bell's palsy). Dtsch Ärztebl Int 116(41): 692-702.
Holland, N.J., Weiner, G.M. 2004. Recent developments in Bell's palsy. BMJ 329(7465): 553-7.
Jiao, W., Zhong, J., Sun, H., Zhu, J., Zhou, Q.M., Yang, X.S., Li, S.T. 2013. Microvascular decompression for the patient with painful tic convulsif after Bell palsy. J Craniofac Surg 24(3): e286-e89.
Lagman, C., Choy, W., Lee, S.J., Chung, L.K., Bui, T.T., Yang, I., Goldman, H.W. 2016. A Case of Bell's palsy with an incidental finding of a cerebellopontine angle lipoma. Cureus 8(8): 1-6.
Lee, K.B., Kim, J.H., Park, Y.A., Park, Y.G., Lee, W., and Son, E.J. 2011. Evaluation of Trigeminal Nerve Involvement Using Blink Reflex Test in Bell's Palsy. Korean J Audiol 15: 129-32.
Lee, S., Lew, H. 2019. Ophthalmologic clinical features of facial nerve palsy patients. Korean J Ophthalmol 33(1): 1-7.
Lee, S.Y., Kim, S.H., Ha, S.G. 2018. Bilateral optic nerve involvement combined with unilateral facial palsy in a patient with acute myeloid leukaemia: a case report. Neuroophthalmology 42(2): 122-5.
Maller, T., Goldenstein, S., Ronen, O. 2018. Prevalence and characteristics of hearing loss in patients diagnosed with Bell's palsy. Eur Arch Otorhinolaryngol 275(1): 99-102.
McCandless, G.A., Schumacher, M.H. 1979. Auditory dysfunction with facial paralysis. Arch Otolaryngol 105(5): 271-4.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G. 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7): 1-6.
Moola, S., Munn, Z., Tufanaru, C., Aromataris, E.C., Sears, K., Sfetcu, R., Currie, M.J., Lisy K., Qureshi, R., Mattis, P., Mu, P. 2017. Chapter 7: Systematic reviews of etiology and risk. In JBI Manual fornEvidence Synthesis. The Joanna Briggs Institute 5.
Prud’hon, S., Kubis, N. 2018. La paralysie faciale périphérique a frigore Bell's palsy. Rev Med Interne 40(1): 28-37.
Rosenhall, U., Edström, S., Hanner, P., Badr, G., Vahlne, A. 1983. Auditory brain stem response abnormalities in patients with Bell's palsy. Otolaryngol Head Neck Surg. 91(4): 412-6.
Sackett, D.L. 1989. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95: 2S-4S.
Shaikh, Z.A., Bakshi, R., Wasay, M., Dai, A., Gosy, E. 2000. Magnetic resonance imaging findings in bilateral Bell's palsy. J Neuroimaging 10(4): 223-5.
Tawfik, E.A., Walker, F.O., Cartwright, M.S. 2015. A pilot study of diagnostic neuromuscular ultrasound in Bell's Palsy. J Neuroimaging 25(4): 564-70.
Tiemstra, J.D., Khatkhate, N. 2007. Bell's palsy: diagnosis and management. Am Fam Physician 76(7): 997-1002.
Welkoborsky, H.J, Amedee, R.G., Elkhatieb, A., Mann, W.J. 1991. Auditory-evoked brain-stem responses and auditory disorders in patients with Bell's palsy. Eur Arch Otorhinolaryngol 248(7): 417-9.
Wormald, P.J., Rogers, C., Gatehouse, S. 1995. Speech discrimination in patients with Bell's palsy and a paralysed stapedius muscle. Clin Otolaryngol Allied Sci 20: 59-62.
Yilmaz, H.B., Safak Yalcin, K., Çakan, D., Paksoy, M., Erdogan, B.A., Sanli, A. 2015. Is there a relationship between Bell's palsy and internal auditory canal?. Indian J Otolaryngol Head Neck Surg, 67(3): 319-23.
Zhang, W., Xu, L., Luo, T., Wu, F., Zhao, B., Li, X. 2019. The etiology of Bell's palsy: a review. J Neurol 267(7): 1896-905.
