Diagnostic values of leukocyte, neutrophil, and neutrophil to lymphocyte ratio in distinguishing central facial paralysis from peripheral facial paralysis.

ABSTRACT

OBJECTIVE: Misdiagnosis of central facial palsy (CFP) as peripheral facial palsy (PFP) can lead to serious consequences clinically. It is unknown whether the leukocyte counts (leukocyte), neutrophil counts (neutrophil), and neutrophil to lymphocyte ratio (NLR) can be used to distinguish CFP from PFP. METHODS: Of the total 152 patients admitted for acute facial paralysis, 76 CFP patients (CFP group) caused by acute ischemic stroke (AIS) and 76 PFP cases (PFP group) without AIS were enrolled in this retrospective study. The levels of blood leukocyte, neutrophil, lymphocyte, platelet counts (platelet), NLR, and platelet to lymphocyte ratio (PLR) before or upon admission were recorded and compared between the two groups. The student t-test was adopted for comparison of the mean. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS: Compared with PFP group, the levels of leukocyte, neutrophil, and NLR were significantly increased in CFP group (all p < 0.01), and there were still significantly statistical differences (all p < 0.01), even after adjusting for age, gender, and past medical history, while no significantly statistical differences of lymphocyte, platelet, and PLR were found between CFP and PFP (all p > 0.05); furthermore, the AUC in distinguishing CFP from PFP were 0.629, 0.671, and 0.657 for leukocyte, neutrophil, and NLR, respectively, and no significant difference of AUC was observed among leukocyte, neutrophil, and NLR (p > 0.05); finally, the cutoff values (specificity, sensitivity, and Youden index) in distinguishing CFP from PFP were 7.08 × 109/L (65.79%, 57.89%, 0.237) for leukocyte, 4.90 × 109/L (73.68%, 60.53%, 0.342) for neutrophil, and 2.88 (72.37%, 55.26%, 0.276) for NLR, respectively. CONCLUSIONS: As easy-to-obtain and inexpensive inflammatory biomarkers, leukocyte, neutrophil, and NLR could demonstrate diagnostic values in distinguishing between CFP and PFP.