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Abstract Details

Facial Nerve Enhancement on MRI Associated With A Longer Course of Bell’s Palsy?
General Neurology
P15 - Poster Session 15 (12:00 PM-1:00 PM)
6-009
To correlate facial nerve enhancement on MRI with the symptomatology and prognosis of Bell’s palsy.
Bell’s palsy involves weakness in the muscles of facial expression and may be disfiguring, socially isolating, and at times debilitating due to vision loss from corneal dehydration. Although facial weakness often spontaneously resolves after several weeks, some persist for months to years and rarely indefinitely. Advances and increasing use of neuroimaging, such as magnetic resonance imaging (MRI), may provide valuable prognostic insight into Bell’s palsy.
We retrospectively studied the University of Miami’s Epic database using SlicerDicer for search-term diagnoses of Bell’s palsy, facial nerve dysfunction, and idiopathic peripheral facial paralysis with brain MRI with gadolinium from January 2019 to August 2019.
Preliminary analysis of 7 patients with Bell’s palsy and brain MRI studies were divided into two groups, one with facial nerve enhancement and one group without. Four patients showed enhancement of the facial nerve of which 2 patients had persistent facial weakness of >9 months and the other two recovered within 3 months. Similarly, the 3 patients with no facial nerve enhancement required 3 weeks to >2 years for recovery from facial weakness. The mean House-Brackmann scale was 3.75 (moderate to severe) for the 4 patients with facial nerve enhancement and 3 (moderate) for patients with no facial nerve enhancement. The location of facial nerve enhancement did not predict loss of taste, dysacusis, altered secretion of lacrimal or salivary glands, prodrome, and ear/mastoid pain.
Our preliminary results suggest poor prognostic value for MRI facial nerve enhancement in Bell’s palsy, which also did not predict other associated symptoms. A larger sample analysis is pending. Though the prognostic value of MRI maybe poor in Bell’s palsy, MRI identified secondary causes of facial nerve weakness initially thought to be Bell’s palsy
Authors/Disclosures
Nestor Beltre, MD
PRESENTER
Dr. Beltre has nothing to disclose.
Hsien Lee Lau, MD No disclosure on file
David J. Adams, MD (U of Miami) No disclosure on file