Increased stroke risk in Bell's palsy patients without steroid treatment

Eur J Neurol. 2013 Apr;20(4):616-22. doi: 10.1111/j.1468-1331.2012.03765.x. Epub 2012 Jun 4.


Background and purpose: To investigate the risk of stroke development following a diagnosis of Bell's palsy in a nationwide follow-up study.

Methods and materials: Information on Bell's palsy and other factors relevant for stroke was obtained for 433218 eligible subjects without previous stroke who had ambulatory visit in 2004. Of those, 897 patients with Bell's palsy were identified. Over a median 2.9 years of follow-up, 4581 incident strokes were identified. We estimated hazard ratios (HR) and 95% confidence intervals [CI] with Cox proportional hazard models adjusting for age, sex, co-morbidities, and important risk factors. Standardized incidence ratio of stroke amongst patients with Bell's palsy was analyzed.

Results: Compared with non-Bell's palsy patients, patients with Bell's palsy had a 2.02-times (95% CI, 1.42-2.86) higher risk of stroke. The adjusted HR of developing stroke for patients with Bell's palsy treated with and without systemic steroid were 1.67 (95% CI, 0.69-4) and 2.10 (95%, 1.40-3.07), respectively.

Conclusions: Patients with Bell's palsy carry a higher risk of stroke than the general population. Our data suggest that these patients might benefit from a more intensive stroke prevention therapy and regular follow-up after initial diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bell Palsy / complications*
  • Bell Palsy / drug therapy*
  • Bell Palsy / epidemiology
  • Diabetes Mellitus / epidemiology
  • Endpoint Determination
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • International Classification of Diseases
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • National Health Programs / statistics & numerical data
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk
  • Sex Factors
  • Steroids / therapeutic use*
  • Stroke / complications*
  • Stroke / epidemiology
  • Stroke / mortality
  • Survival Analysis
  • Taiwan / epidemiology


  • Steroids