Kopitović Aleksandar, Katanić Filip, Kalember Sandro, Simić Svetlana, Vico Nina, Sekulić Slobodan
Faculty of Medicine, University of Novi Sad, 3 Hajduk Veljkova Street, 21000 Novi Sad, Serbia.
Department of Neurology, Clinical Center of Vojvodina, 1-9 Hajduk Veljkova Street, 21000 Novi Sad, Serbia.
Medicina (Kaunas). 2021 Mar 13;57(3):263. doi: 10.3390/medicina57030263.
Non-motor symptoms in the form of increased sensitivity are often associated with the onset of idiopathic Bell's palsy (IBP). The aims were to determine whether the pain threshold in the retroauricular regions (RAR) in IBP patients and the time of its occurrence is related to IBP severity. The study was conducted among 220 respondents (142 IBP patients, 78 healthy subjects (HS)). The degree of IBP was graded using the House-Brackmann and Sunnybrook Grading Scales (II-mild dysfunction, VI-total paralysis), whereas the pain thresholds were measured using the digital pressure algometer. We found no difference in the degree of the pain threshold between the right and left RAR in the HS group. IBP patients belonging to groups II, III, IV, and V had lower pain thresholds in both RARs than HS and IBP patients belonging to group VI. There was no difference in the degree of pain threshold in RAR between the affected and unaffected side in IBP patients. The incidence of retroauricular pain that precedes paralysis and ceases after its occurrence in groups II and III of IBP patients is noticeably lower and the incidence of retroauricular pain that occurred only after the onset of paralysis is more frequent. Also, we found that the incidence of retroauricular pain that precedes paralysis and ceases after its occurrence in groups V and VI of IBP patients was more frequent. The degree of pain threshold lowering in RAR (bilaterally) is inversely related to the severity of IBP. We suggest that the occurrence of retroauricular pain before the onset of facial weakness is associated with higher severity of IBP while the occurrence after the onset is associated with lower severity of IBP.
以敏感性增加为表现形式的非运动症状常与特发性贝尔面瘫（IBP）的发病相关。本研究旨在确定IBP患者耳后区域（RAR）的疼痛阈值及其出现时间是否与IBP严重程度有关。该研究共纳入220名受试者（142例IBP患者，78名健康对照者（HS））。采用House - Brackmann和Sunnybrook分级量表对IBP程度进行分级（II级 - 轻度功能障碍，VI级 - 完全瘫痪），同时使用数字压力痛觉计测量疼痛阈值。我们发现HS组左右RAR的疼痛阈值程度无差异。II、III、IV和V组的IBP患者双侧RAR的疼痛阈值均低于HS组以及VI组的IBP患者。IBP患者患侧与未患侧RAR的疼痛阈值程度无差异。II组和III组IBP患者中，面瘫前出现且面瘫后消失的耳后疼痛发生率明显较低，而仅在面瘫发作后出现的耳后疼痛发生率更高。此外，我们还发现V组和VI组IBP患者中，面瘫前出现且面瘫后消失的耳后疼痛发生率更高。RAR（双侧）疼痛阈值降低的程度与IBP严重程度呈负相关。我们认为，面部无力发作前出现耳后疼痛与较高的IBP严重程度相关，而发作后出现则与较低的IBP严重程度相关。
