Dawidowsky Krsto, Branica Srecko, Kovac Bilic Lana, Bosnjak Zrinka, Pastorcic-Grgic Marija, Poje Gorazd, Dawidowsky Barbara
Department of ENT&HNS, Zagreb University Hospital Center, School of Medicine, University of Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
Department of Microbiology, Zagreb University Hospital Center, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
J Clin Med. 2025 Jul 26;14(15):5290. doi: 10.3390/jcm14155290.
The aetiology of Bell's palsy remains unclear and is typically diagnosed by exclusion. This study investigated the potential role of neurotropic viruses and explored the relationship between facial nerve impairment and vestibular dysfunction to improve the understanding of the condition. Antibodies against herpes simplex virus (HSV) and varicella-zoster virus (VZV) were assessed using ELISA. Vestibular function was evaluated through computerised videonystagmography, rotatory chair, and clinical vestibulospinal assessments. Facial nerve lesion localisation was determined by stapedial reflex testing. Fisher's exact test was used for statistical analysis. Of 51 patients with Bell's palsy, 62.7% exhibited vestibular dysfunction, and 70.6% were IgG-positive for at least one neurotropic virus. Vestibular impairment was significantly more common in seropositive patients. Statistically significant associations were observed between vestibular dysfunction and viral IgG seropositivity ( < 0.0001), the severity of vestibular dysfunction and facial paresis ( = 0.0126), and the side of vestibular impairment and the side of facial palsy ( < 0.0001), with 90.6% of cases showing ipsilateral involvement. : These findings support the hypothesis that neurotropic viruses may act as a common pathological factor in both Bell's palsy and associated vestibular dysfunction.
贝尔面瘫的病因尚不清楚，通常通过排除法进行诊断。本研究调查了嗜神经病毒的潜在作用，并探讨了面神经损伤与前庭功能障碍之间的关系，以增进对该疾病的了解。使用酶联免疫吸附测定法评估针对单纯疱疹病毒（HSV）和水痘-带状疱疹病毒（VZV）的抗体。通过计算机化视频眼震图、转椅试验和临床前庭脊髓评估来评估前庭功能。通过镫骨肌反射测试确定面神经病变的定位。采用Fisher精确检验进行统计分析。在51例贝尔面瘫患者中，62.7%表现出前庭功能障碍，70.6%至少对一种嗜神经病毒IgG呈阳性。血清阳性患者中前庭损伤明显更为常见。在前庭功能障碍与病毒IgG血清阳性之间（<0.0001）、前庭功能障碍的严重程度与面部麻痹之间（=0.0126）以及前庭损伤侧与面瘫侧之间（<0.0001）观察到具有统计学意义的关联，90.6%的病例表现为同侧受累。：这些发现支持了嗜神经病毒可能是贝尔面瘫和相关前庭功能障碍共同病理因素的假说。
