The two authors contributed equally to this manuscript.
Increased stroke risk in Bell's palsy patients without steroid treatment
Article first published online: 4 JUN 2012
© 2012 The Author(s) European Journal of Neurology © 2012 EFNS
European Journal of Neurology
Volume 20, Issue 4, pages 616–622, April 2013
How to Cite
Lee, C.-C., Su, Y.-C., Chien, S.-H., Ho, H.-C., Hung, S.-K., Lee, M.-S., Chou, P., Chiu, B. C.-H. and Huang, Y.-S. (2013), Increased stroke risk in Bell's palsy patients without steroid treatment. European Journal of Neurology, 20: 616–622. doi: 10.1111/j.1468-1331.2012.03765.x
- Issue published online: 12 MAR 2013
- Article first published online: 4 JUN 2012
- Manuscript Accepted: 24 APR 2012
- Manuscript Received: 16 FEB 2012
- Buddhist Dalin Tzu Chi General Hospital. Grant Number: DTCRD 1002-I-12
- Bell's palsy;
Background and purpose
To investigate the risk of stroke development following a diagnosis of Bell's palsy in a nationwide follow-up study.
Methods and materials
Information on Bell's palsy and other factors relevant for stroke was obtained for 433 218 eligible subjects without previous stroke who had ambulatory visit in 2004. Of those, 897 patients with Bell's palsy were identified. Over a median 2.9 years of follow-up, 4581 incident strokes were identified. We estimated hazard ratios (HR) and 95% confidence intervals [CI] with Cox proportional hazard models adjusting for age, sex, co-morbidities, and important risk factors. Standardized incidence ratio of stroke amongst patients with Bell's palsy was analyzed.
Compared with non-Bell's palsy patients, patients with Bell's palsy had a 2.02-times (95% CI, 1.42–2.86) higher risk of stroke. The adjusted HR of developing stroke for patients with Bell's palsy treated with and without systemic steroid were 1.67 (95% CI, 0.69–4) and 2.10 (95%, 1.40–3.07), respectively.
Patients with Bell's palsy carry a higher risk of stroke than the general population. Our data suggest that these patients might benefit from a more intensive stroke prevention therapy and regular follow-up after initial diagnosis.