Association Between Clinical Symptoms, Electrodiagnostic Findings, Clinical Outcome, and Prodromal Symptoms in Patients With Bell's Palsy

Ann Otol Rhinol Laryngol. 2023 Jan;132(1):27-34. doi: 10.1177/00034894221075107. Epub 2022 Feb 3.


Objective: This study aimed to determine which prodromal symptoms frequently occur in patients with Bell's palsy and evaluate the association between these symptoms and clinical severity of paresis or the severity of facial nerve injury.

Materials and methods: The study included 86 patients with Bell's palsy between August 2018 and April 2020. Severity levels of Bell's palsy and facial nerve damage were evaluated using the House-Brackmann (H-B) grading scale and electrodiagnostic study, respectively. Subsequently, a self-reported questionnaire on prodromal symptoms was administered. To assess the degree of recovery, the H-B grade was reported at 9 weeks and 6 months after the onset of paralysis.

Results: The most common prodromal symptoms were postauricular pain, sensory decline in the tongue, headache on the affected side, myalgia, facial sensory decline on the affected side, taste impairment, and dry eye. Taste impairment was significantly correlated with severe facial paralysis reported at 9 weeks after onset (P < .05) and was not related to the severity of paresis assessed at initial examination or 6 months after onset or on electrodiagnostic findings.

Conclusions: The prodromal symptoms of Bell's palsy were not associated with the severity of facial nerve injury in an electrodiagnostic study. Taste impairment was related to clinical severity of paralysis at subacute stage, 9 weeks after onset, but it was not associated with long-term prognosis.

Keywords: Bell’s palsy; House-Brackmann grading scale; electrodiagnosis; facial nerve; prodromal symptoms.

MeSH terms

  • Bell Palsy* / diagnosis
  • Facial Nerve Injuries*
  • Facial Paralysis* / diagnosis
  • Facial Paralysis* / etiology
  • Humans
  • Paresis
  • Prodromal Symptoms