Can Otitis Media Cause Bell’s Palsy & Is It Related To Lupus?

Facial nerve palsy has become a mysterious complication of acute otitis media in the current decade.1, 2

Facial nerve palsy is the most common cause of mononeuropathy, and potential triggers appear to be related to this condition.3

Central nervous system (CNS) involvement in systemic lupus erythematosus and account for a small percentage of neuropsychiatric manifestations.4

Bell’s palsy can affect anyone at any age but most commonly notice in people between 15 and 60 years of age. But most people recover very soon, but people who take time to recover may feel weak on one side of the face with reduced facial functionalities.

The symptoms vary in severity and can range from mild disruptions to complete paralysis. Risk factors include pregnancy, diabetes, high blood pressure, and upper respiratory diseases.

Can Otitis Media Cause Bell’s Palsy?

Facial nerve palsy has become a mysterious complication of acute otitis media in the current decade. The condition requires early detection with immediate treatment.

Medical studies have proven evidence of cases with good outcomes. A review of the literature shows that antibiotic therapy and corticosteroids were found to be the first line of treatment. Surgery may be required during severe conditions or acute cases of coalescent mastoiditis where clinical therapies don’t produce desirable outcomes.

Otis media is the inflammatory disease of the inner ear when there is a swelling or fluid buildup without bacterial or viral infection. Clinical research was conducted on a 25-year-old patient who had a history of ear infection. She complained of water discharge in the right year for 2 days associated with blood tinge. The patient’s symptoms were not improving with oral analgesic and she complained of drooping of the face. She also had problems with closing her right eye for 2 days.

Electroneurography was performed on this patient and the diagnosis showed right acute suppurative otitis media with right facial nerve palsy. Minor facial nerve paralysis in acute otitis media is uncommon but usually resolves with conservative therapy. In the case of the failure of conventional therapy, facial nerve decompression may be helpful.1,2

Is Bell’s Palsy Related To Lupus?

Facial nerve palsy is the most common cause of mononeuropathy, and potential triggers appear to be related to this condition. Nevertheless, peripheral neuropathy could also be a symptom of an essential autoimmune disorder. Bell’s palsy becomes the most common cause of the disease. However, cranial neuropathy particularly when it comes to facial palsy is a rare disease in systemic lupus erythematosus (SLE).3

SLE, an autoimmune disease in which the body mistakenly attacks the healthy tissues and eventually affects the skin, kidney, brain, and other organs. The clinical report showed a female patient in her early twenties had recurrent facial palsy and she was diagnosed that she already had SLE. Central nervous system (CNS) involvement in systemic lupus erythematosus and account for a small percentage of neuropsychiatric manifestations. She was under steroid treatment with which she started to slow progress in her symptoms.

Face drooping may occur anytime during the disease, but the first symptom is rarely the SLE. Immunosuppression is generally the choice of treatment in these patients.4

References:

  1. Prior, A.J. “Facial Palsy Caused by Otitis Media with Effusion: The Pathophysiology Discussed.” ORL, Karger Publishers, 13 Jan. 2010, www.karger.com/Article/PDF/276779.
  2. Prasad, Sriranga, et al. “Facial Nerve Paralysis in Acute Suppurative Otitis Media-Management.” Indian Journal of Otolaryngology and Head and Neck Surgery: Official Publication of the Association of Otolaryngologists of India, Springer India, Mar. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5305654/.
  3. Gupta, Durgesh Kumar, et al. “Recurrent Lower Motor Neuron Type Facial Palsy: an Unusual Manifestation of SLE.” BMJ Case Reports, BMJ Publishing Group, 2 Feb. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3062381/.
  4. Kazzaz, Nayef Mohammed, and Rasha El-Rifai. “Unusual Aetiology of Isolated Lower Motor Neuron Facial Palsy: Systemic Lupus Erythematosus Presenting with Cranial Nerve Palsy and Nephritis.” BMJ Case Reports, BMJ Publishing Group, 26 Aug. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3762451/.

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