This article has presented findings from a prospective study that examined the risk of developing stroke after a diagnosis of Bell’s palsy. Three reasons informed the selection of this journal. First, Bell’s palsy has a poor prognosis because it has no cure or prevention (Parjapati, Modi, Modi, & Dave, 2013). Secondly, the use of steroids is essential in the management of Bell’s palsy. According to Lee, Bryun, Park, & Yeo, (2013b), steroids alone can treat this disease efficaciously. Conversely, Parjapati et al. have recommended the inclusion of vasodilators, antiviral, and neurotonics. Thirdly, (Chiu, Yen, Chen, & Pan, 2012) have found out that patients suffering from Bell’s palsy are more vulnerable to the risk of stroke than the general population. As such, the review of the study will determine whether the use of steroids reduces the risk of stroke in patients with Bell’s palsy.
The primary goal of this research was to determine the frequency of stroke in patients suffering from Bell’s palsy. The findings from this study have provided invaluable insights that will enhance the existing knowledge. First, Lee et al. (2013a) found out that the risk of stroke was higher in patients with Bell’s palsy. The probability of developing stroke did not reduce even after the researchers controlled the underlying risk factors. One of the most significant results that have emerged from this study is that the administration of steroids minimizes vulnerability. In addition, the patients who received systemic steroid therapy had a lower risk of suffering from a stroke. By contrast, the risk of stroke remained elevated in the subjects who did not receive the steroid treatment.
Secondly, steroids can alter the risk of stroke in Bell’s palsy significantly. Lee et al. (2013b) have identified short-term oral glucocorticoid as the first-line pharmacological therapy for managing the symptoms of Bell’s palsy. Lee et al. (2013a) have opined that this mainstay treatment can prevent the onset of stroke during the initial stage of Bell’s palsy. Parjapati et al. (2013) have noted that the delay in the management of Bell’s palsy induces the onset of debilitating symptoms. Glucocorticoids medications are effective because of their anti-inflammatory activity. Despite their clinical efficacy, Lee et al. (2013b) have argued that steroids can increase the severity of diabetes, dyslipidemia, and hypertension. Conversely, Lee et al. (2013a) have found out that patients with Bell’s palsy can receive glucocorticoids in high doses with little risk of developing the previous diseases.
Only 23.1% percent of the 897 patients who participated in the present study received systemic steroid treatment. Although this number is insignificant, Lee et al. (2013a) have asserted that oral glucocorticoids might benefit the patients with Bell’s palsy. Nonetheless, these researchers have acknowledged the need to conduct additional studies. The Clinical trials will determine the clinical efficacy of steroids in preventing the first case of stroke. Virus vasculopathy often precedes stroke, and this causal relationship had received much attention in the literature (Lee et al., 2013b). According to Lee et al. (2013a), the risk of stroke causes the reactivation of HSV-1 in some cases of Bell’s palsy. One of the viral conditions that contribute to the mechanisms of vasculopathy and HSV-induced cerebrovascular is Herpes. A clear understanding of these mechanisms will form the basis for formulating the clinical trials.
The present study has also investigated the therapeutic implications of a higher risk of stroke. Thirteen patients (41%) who participated in the research developed stroke within the first six months. According to Lee et al. (2013a), Bell’s palsy was the principal underlying factor that caused the stroke. In addition, these researchers observed that the predisposing risks of cerebrovascular disease increased dramatically in patients with Bell’s palsy. For instance, Chiu et al. (2012) have indicated that hypertensive and diabetic patients are highly susceptible to the risk of Bell’s palsy. As such, Lee et al. (2013a) have recommended the implementation of rigorous, stroke prevention strategies during the duration of increased risk. Some of these therapies include the control of the factors that cause vascular diseases. For instance, the strict control of sugar, blood pressure, and cholesterol levels is of the essence during the first six months that follow the onset of Bell’s palsy.
Another crucial finding of this study is the fundamental role that brain imaging plays during the diagnostic stage. Lee et al. (2013a) have underscored the need to reevaluate this practice considering the chances of making an incorrect diagnosis. Parjapati et al. (2013) have argued that clinicians often confuse Bell’s palsy with stroke since both diseases have similar clinical manifestations. Thus, Lee et al. (2013a) have proposed the use of imaging as a means of diagnosing idiopathic facial paralysis if the patient shows no improvement within three months. A slow pace in the progression of the condition also warrants the use of imaging. Medical imaging is essential to differentiate between central facial and peripheral facial palsy. Conversely, it is imperative to ascertain the cost-effectiveness of using MRI and CT scans in patients with non-traumatic and acute peripheral facial palsy.
References
Chiu, Y. N., Yen M. F., Chen, L. S., Pan, S. L. (2012). Increased risk of stroke after Bell’s palsy: A population-based longitudinal follow-up study. Journal of Neurological Neurosurgery and Psychiatry, 83, 341–343.
Lee, H. Y., Bryan, J. Y., Park, M. S, Yeo, S. G. (2013b). Steroid-antiviral treatment improves the recovery rate in patients with severe Bell ’s palsy. American Journal of Medicine,126(4), 336–341.
Parjapati, V., Modi, M., Modi, P. & Dave, V. (2013). Prospective observational study of Bell’s palsy. National Journal of Integrated Research in Medicine, 4(2), 162-168.