Younger Onset Age and Early Treatment Benefit Women with Bell’s Palsy

by Linda Kossof •

CLINICAL QUESTION

Do the clinical features and treatment results, and the factors affecting them, differ between male and female patients with Bell’s palsy?

BOTTOM LINE

Younger onset age and early-stage steroid treatment were associated with a higher recovery rate in women, but not in men.

BACKGROUND: The causes, pathogenesis, and optimal treatment methods for Bell’s palsy are unclear; however, recovery is associated with factors that include age, comorbidities, treatment timing and modalities, and neurological exam results. Few studies have analyzed whether the clinical features and treatment outcomes of Bell’s palsy differ between men and women.

STUDY DESIGN: Retrospective study

SETTING: Center for Digital Health, Medical Science Research Institute, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea

SYNOPSIS: Researchers retrospectively analyzed 1,708 patients (917 women, mean age 48.26 years; 791 men, mean age 46.83 years) diagnosed with idiopathic facial palsy or Bell’s palsy at a single institution between January 1986 and December 2022. Patients were divided by gender and age at initial visit, initial House-Brackmann (HB) grade, electroneuronography (ENoG) results, electromyography (EMG) results, presence/absence of diabetes and hypertension, treatment method, treatment start time, and recovery rate. Recovery was assessed at six months, with HB grades I and II defined as satisfactory. Clinical features and treatment outcomes were compared in men and women. Age distribution, side affected by facial palsy, HB grade, underlying diseases such as diabetes and hypertension, ENoG results, EMG results, and treatment methods did not differ significantly between men and women. Factors significantly associated with better prognosis in men included milder initial facial palsy and better EMG results. Factors significantly associated with better prognosis in women included younger age, milder initial facial palsy, and better EMG results. Women had a significantly better prognosis than men when treated with steroids within three days of the onset of paralysis. Authors note that the effects of steroid treatment may have been altered by hormones, which differ between men and women.

CITATION: Yon DK, et al. A retrospective study on the gender differences in clinical manifestations of Bell’s palsy. Clin Otolaryngol. 2024. doi:10.1111/coa.14259.