CLINICAL AND NEUROLOGICAL FEATURES AND VARIANTS OF THE COURSE OF DIABETIC NEUROPATHY OF THE FACIAL NERVE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Keywords:
type 2 diabetes mellitus, facial nerve neuropathy, Bell's palsy, clinical features, diagnosis, polyneuropathy.Abstract
Aim. To study the peculiarities of clinical manifestations and variants of the course of facial nerve neuropathy (FNN) in patients with type 2 diabetes mellitus (T2DM).
Materials and Methods. The study involved 120 patients with acute peripheral paresis of the facial muscles. The main group consisted of 60 patients with T2DM and FNN, while the comparison group included 60 patients with idiopathic facial nerve neuropathy (Bell's palsy) without impaired carbohydrate metabolism. A neurological examination, assessment using the House-Brackmann scale, and analysis of glycated hemoglobin (HbA1c) levels were performed.
Results. It was established that patients with T2DM more frequently presented with bilateral (6.7% vs 0%) and recurrent (15% vs 3.3%) lesions of the facial nerve. The clinical picture of diabetic FNN was characterized by a less acute onset, a more pronounced pain syndrome in the ear region during the prodromal period, and a tendency to develop severe paresis (House-Brackmann grade III–V in 68.3% of cases). The frequency of concomitant distal polyneuropathy in the main group was 78.3%.
Conclusion. Diabetic neuropathy of the facial nerve has characteristic clinical and neurological features requiring a differentiated therapeutic approach that takes into account metabolic disorders.
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