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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.4 São Paulo  1997

http://dx.doi.org/10.1590/S0004-282X1997000500007 

Clusters of Bell's palsy

 

"Surtos" da paralisia de Bell

 

 

Thiago D. Gonçalves-CoêlhoI; Carlos Newton D. PinheiroI; Ezon V.A.P. FerrazII; José Luiz Alonso-NietoIII

IMedicine student. Federal University of Paraíba Campus II, Intern HSPE/FMO
IIMedicine student, Federal University of Maranhão, Intern HSPE/FMO
IIINeurologist, EMG Sector Director, HSPE/FMO

 

 


ABSTRACT

The idiopathic facial paralysis or Bell's palsy installs abruptly or within a few hours, without any apparent cause. It corresponds to approximately 75% of all peripheral facial palsies. Three theories try to explain its pathogenecity: vascular-ischemic, viral and auto-immune. We reviewed the records of the EMG Sector, Hospital do Servidor Público Estadual (São Paulo, Brazil), from 1985 to 1995 and found 239 cases of Bell's palsy. Data were analysed according to age, gender, seasonal distribution of cases. There was a predominance of cases in the 31 - 60 age bracket (40.59 %). The female gender was responsible to 70.71 % of cases. There was a predominance of cases in winter (31.38 %) and autumn (30.13 %), which was statiscally significant. These findings let us to suppose that Bell's palsy predominates in females, in 41-60 years age bracket, and occurs predominantly in cold months. There are groups of clusters throughout temporal distribution of cases and cases are dependent on one each other or on factors affecting them all, which reinforces the infectious hypothesis (there is a rise in the incidence of viral upper respiratory tract infection during cold months).

Key words: Bell's palsy, facial paralysis, electromyography, sazonality, epidemiology.


RESUMO

A paralisia facial idiopática ou paralisia de Bell se instala abruptamente ou em algumas horas, sem causa aparente. Corresponde a aproximadamente 75% de todos os casos de paralisia facial. Três teorias tentam explicar sua patogenia: vásculo-isquêmica, autoimune e viral. Nós revisamos os arquivos do Setor de Eletromiografia do Hospital do Servidor Público Estadual (São Paulo) de 1985 a 1995, encontrando 239 casos de paralisia de Bell. Dados foram analisados quanto a idade, sexo, distribuição sazonal. Houve predominância dos casos na faixa etária de 31 a 60 anos (40,59 %). O sexo feminino foi responsável por 70,71 % dos casos. Houve predominância de casos no inverno (31,38 %) e outono (30,13 %), estatisticamente sigmficante. Estes achados levam-nos a supor que a paralisia de Bell predomina nas mulheres, entre 41-60 anos, ocorre predominantemente nos meses frios. Há aglutinação de casos na distribuição temporal e dependência dos casos, entre si ou a fatores comuns, o que fala a favor da hipótese infecciosa (há aumento da incidência de infecções virais do trato respiratório superior durante os meses frios).

Palavras-chave: paralisia de Bell, paralisia do nervo facial, eletromiografia, sazonalidade, epidemiologia.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

Acknowledgements - We would like to thank to Prof. Dr. Luís dos Ramos Machado, for the statistical methodology orientation. We dedicate this study to the memory of Mrs. Eunice Diniz Coelho.

 

REFERENCES

1. Adour KK, Wingerd J. Nonepidemic incidence of idiopathic facial paralysis: seasonal distribution of 419 cases in three years. JAMA 1974,227:653-654.         [ Links ]

2. Almeida MA. M. Paralisia facial periférica em Petrópolis. Arq Neuropsiquiatr 1992;50:60-64.         [ Links ]

3. Buzelle R, Alonso-Nieto JL. Estudo de 433 casos de paralisia facial periférica de Bell no HSPE. In Anais XXIX Congresso Brasileiro de Otorrinolaríngologia. Salvador 1988:13.         [ Links ]

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5. Frumkim H, Horowitz M, Jabre JF, Payton M, Kantrowitz W. An investigation of a workplace cluster of Bell's palsy. JOM 1992;34:1064-1070.         [ Links ]

6. Hauser WA, Karnes WE, Annis J, Kurland LT. Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clin Proc 1971;46:258-264.         [ Links ]

7. Leibowitz U. Bell's palsy: two disease entities? Neurology 1966;16:1105-1109.         [ Links ]

8. Leibowitz U. Epidemic incidence of Bell's palsy. Brain 1969;92:109-114.         [ Links ]

9. Pereira JCR, Stuginsky LA, Ribeiro TVM. Assessment of a strategy to control respiratory diseases in children. Rev Saúde Públ 1992;26:414-423.         [ Links ]

10. Testa JRG, Fukuda Y. Paralisia facial periférica isolada: da incidência e dos fatores prognósticos. Acta AWHO 1993; 12:9-18.         [ Links ]

 

 

Aceite: 25-agosto-1997.

 

 

This study is part of the Dissertation (Intern Program) presented on July, 1997 at Hospital do Servidor Público Estadual (HSPE/FMO), São Paulo, Electromyography (EMG) Sector, Department of Neurology.
Thiago D. Gonçalves-Coêlho - Rua Joaquim Antunes 148/ 91 - 05415-000 São Paulo SP - Brasil.