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Keywords:

  • Bell’s palsy;
  • peripheral facial palsy;
  • facial palsy and prediabetes;
  • neuropathy and diabetes;
  • 2-h oral glucose tolerance test;
  • hyperinsulinemia

Bosco D, Plastino M, Bosco F, Consoli A, Labate A, Pirritano D, Consoli D, Fava A. Bell’s palsy: a manifestation of prediabetes? Acta Neurol Scand: 2011: 123: 68–72. © 2010 John Wiley & Sons A/S.

Background –  Idiopathic peripheral facial nerve palsy or Bell’s palsy (BP) is the most common cause of facial nerve palsy.

Objective –  To evaluate the role of glucose metabolism abnormalities in BP. Methods– We identified 148 patients with unilateral BP and 128 control subjects. In all we evaluated glucose level at fasting and after a 2-h oral glucose tolerance test (2h-OGTT). In addition we determined insulin resistance (IR), by HOMA-index. Patients and controls were divided in to two groups, according to their Body Mass Index (BMI).

Results –  Following a 2h-OGTT, the prevalence of glucose metabolism abnormalities was significantly higher in patients with BP than in controls (< 0.001). Impaired glucose tolerance (IGT) was found in 57 (38%) patients and in 23 (18%) controls, while a new-diagnosed DM (NDDM) was found in 29 (19%) patients and in 8 (6%) controls. The IR was significantly increased only in BP patients with BMI ≥ 24.9 (= 0.005). BMI, waist circumference, blood pressure, tryglicerides, serum lipid, drugs use were not significantly different between patients and controls.

Conclusions –  In this study we found that prediabetes is frequently associated with facial palsy. We propose to perform a 2h-OGTT in patients with peripheral facial palsy and normal fasting glycaemia. HOMA-index should be evaluated in obese facial palsy patients.