Study: Migraines May Double the Risk of Bell Palsy

Migraine headaches, with and without aura, may double the risk of Bell’s palsy—a nervous system condition that causes facial paralysis, according to a new study in Neurology.

“We found migraine patients with higher clinical visits, indicating more severe or frequent attacks, were more likely to develop Bell’s palsy. Frequent and repeated attacks might jeopardize the facial nerve,” says study author Shuu-Jiun Wang, MD, with National Yang-Ming University and Taipei Veterans General Hospital in Taipei, Taiwan.
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“This is a purely new unidentified risk factor for Bell’s palsy; previously known risk factors include hypertension, diabetes, and pregnancy,” he says.

The study findings suggest that the two conditions may share an underlying link. The most plausible hypotheses include neurogenic inflammation during migraine and vascular insufficiency.

Wang says migraine is known to induce regional neurogenic inflammation, which could potentially predispose facial nerve to demyelination. Another possibility is that the previously reported asymmetric facial blood distribution may potentially lead to vascular ischemia to facial nerves.

Using data from the Taiwan National Health Insurance Research Database, Wang and his colleagues studied patients who were age 18 and older and had been diagnosed with migraine by a neurologist from 2005 to 2009.

They looked at two groups of 136,704 people—one group with migraine and one without. The patients were followed for an average of 3 years and during that time, 671 in the migraine group and 365 in the non-migraine group were newly diagnosed with Bell’s palsy.

People with migraine were twice as likely to develop Bell’s palsy even after researchers accounted for other factors that could increase the risk of the condition, such as sex, high blood pressure, and diabetes.

“Despite a two-fold increase of hazard ratio, the absolute risk of Bell’s palsy among patients with migraine is relatively low,” Wang says. “At present, we do not have any evidence on preventive measures to reduce the subsequent development of Bell’s palsy. Instead, patients should be aware of this association and seek medical assistance as soon as possible for a better recovery.”

Bell’s palsy is regarded as a treatable disease—with proper treatment, the complete recovery might be up to 96%.

Wang and his colleagues plan to conduct further research in this area. “The first step is to pursue a history of migraine in all patients with Bell’s palsy so we could further investigate whether Bell’s palsy in migraine patients differs when compared to those with hypertension or diabetes patients, i.e., could the outcome be somehow better or worse?” he says.

—Colleen Mullarkey

Reference

Peng K, Chen Y, Fuh J, Tang C, Wang S. Increased risk of Bell palsy in patients with migraine: A nationwide cohort study. Neurology. 17 Dec 2014. [Epub ahead of print].