Increased stroke risk in Bell's palsy patients without steroid treatment

Authors

  • C.-C. Lee,

    1. Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
    2. Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    3. Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    4. School of Medicine, Tzu Chi University, Hualian, Taiwan
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  • Y.-C. Su,

    1. Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    2. School of Medicine, Tzu Chi University, Hualian, Taiwan
    3. Division of Hematology-Oncology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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  • S.-H. Chien,

    1. School of Medicine, Tzu Chi University, Hualian, Taiwan
    2. Division of Plastic Surgery, Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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  • H.-C. Ho,

    1. Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    2. Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    3. School of Medicine, Tzu Chi University, Hualian, Taiwan
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  • S.-K. Hung,

    1. Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    2. School of Medicine, Tzu Chi University, Hualian, Taiwan
    3. Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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  • M.-S. Lee,

    1. Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    2. School of Medicine, Tzu Chi University, Hualian, Taiwan
    3. Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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  • P. Chou,

    1. Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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  • B. C.-H. Chiu,

    Corresponding author
    1. Department of Health Studies, University of Chicago, Chicago, IL, USA
    • Correspondence: Y.-S. Huang, Division of Neurology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, No.2, Ming-Sheng Road, Dalin Town, Chiayi 622, Taiwan (tel.: +886 5 2648000 ext. 5231; fax: +886 5 2648006; e-mail: enttcd@hotamil.com).

      B. C.-H. Chiu, Department of Health Studies, University of Chicago, 5841 S. Maryland Ave., MC, 2007, Rm. N101E, Chicago, IL 60637, USA (tel.: 773 834 7156; fax: 773 834 0139; e-mail: bchiu@uchicago.edu).

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    • The two authors contributed equally to this manuscript.

  • Y.-S. Huang

    Corresponding author
    1. Division of Neurology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • Correspondence: Y.-S. Huang, Division of Neurology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, No.2, Ming-Sheng Road, Dalin Town, Chiayi 622, Taiwan (tel.: +886 5 2648000 ext. 5231; fax: +886 5 2648006; e-mail: enttcd@hotamil.com).

      B. C.-H. Chiu, Department of Health Studies, University of Chicago, 5841 S. Maryland Ave., MC, 2007, Rm. N101E, Chicago, IL 60637, USA (tel.: 773 834 7156; fax: 773 834 0139; e-mail: bchiu@uchicago.edu).

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    • The two authors contributed equally to this manuscript.


Abstract

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.

Results

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.

Conclusions

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.

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