The effect of insulin resistance on House-Brackmann grade of facial paralysis in patients with Bell’s palsy

Gökhan Özer

doi:10.28982/josam.409968

Authors

Gökhan Özer

DOI:

https://doi.org/10.28982/josam.409968

Keywords:

Insulin resistance, House-Brackmann, Facial paralysis

Abstract

Aim: Bell's palsy is the most common cause of facial nerve lesion and is frequently observed in diabetic patients and the duration of healing is delayed in diabetic patients. To investigate the effect of insulin resistance on the facial paralysis as graded by the House-Brackmann classification in patients with Bell’s palsy and to determine the importance of insulin resistance assessed primarily prior to treatment planning .

Methods: Patients admitting to our emergency department and outpatient neurology clinic with suspected facial paralysis who were not administered steroid therapy within the first 24 hours were studied. Demographic data were collected for patients with Bell’s palsy from different age groups with a normal body mass index (BMI) and no chronic endocrine disease. The House-Brackmann (HB) grading scale was used to assess the clinical severity of the facial paralysis. In addition to routine laboratory tests, fasting insulin level was obtained to estimate HOMA-IR (Homeostatic model assessment for insulin resistance) for all patients.

Results: Of 19 patients enrolled, 10 were female (52.6%). Patients had a mean age of 33 years, mean glucose value of 106 mg/dL, mean insulin value of 15.9 µU/mL and mean HOMA-IR value of 4.1. A moderate positive correlation and a statistically significant association were found between mean glucose values and HOMA-IR values (r=0.548; P=0.015) Age and glucose values were not statistically significantly associated with insulin and HOMA-IR values (p=0.858 and p=0.015, respectively).

Conclusion: Higher blood glucose and average insulin levels were found in patients with facial nerve paralysis in comparison to general population. Most of the patients were IR-positive. Therefore, assessment of insulin resistance would be beneficial for both treatment planning and taking proactive measures against future development of diabetes in all patients presenting with Bell’s palsy.

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