RESUMEN
BACKGROUND: Bell's palsy is possibly an ischemic cranial neuropathy, although reactivation of herpes virus infection has been proposed. METHODS: This was an age-and sex-matched and 1:2 case-control study enrolling Bell's palsy patients during 2011-2021 in a university hospital to investigate the significant associations of cardiometabolic risks (CMRs) with Bell's palsy. We analyzed the differences in waist circumference (WC), body mass index (BMI), systolic and diastolic blood pressures (SBP and DBP), fasting blood sugar (FBS), and lipid levels at 12 weeks post-Bell's palsy with those of the controls by descriptive statistics (p < 0.05). The differences in means or medians of individual CMR values across the consecutive 10-year age intervals were analyzed by ANOVA F-tests and Kruskal-Wallis tests (p < 0.05). RESULTS: A total of 140 cases and 280 controls were enrolled. Bell's palsy patients had significantly higher WC, BMI, SBP, DBP, FBS, and triglyceride but lower high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Moreover, high WC, elevated FBS (≥100 mg/dL), SBP (≥130 mmHg), and total cholesterol were significantly associated with Bell's palsy cases by multivariable analysis. Only FBS in Bell's palsy patients significantly elevated across consecutive 10-year age intervals. CONCLUSION: Screening and monitoring for CMRs, especially hyperglycemia, in every patient presenting with Bell's palsy is essential despite initial normoglycemia, particularly in older-onset cases.
RESUMEN
OBJECTIVE: To describe the characteristics of the Behavioral and Psychological Symptoms of Dementia (BPSD) and its severity among patients with dementia and their caregivers' stress. MATERIAL AND METHOD: A cross-sectional descriptive study of 158 patients with Alzheimer's disease, mixed vascular dementia and Alzheimer's disease, and unspecified dementia and caregivers in Songkhla Rajanakarindra Psychiatric Hospital were selected by a consecutive sampling. The BPSD and severity of dementia was assessed with the Neuropsychiatric Inventory Questionnaire - Thai version (NPI-Q Thai), the Global Clinical Dementia Rating Scale (CDR), the Mini Mental Status Thai version 2002 (MMSE Thai 2002), and a clinical diagnosis. Consensus of a psychiatrist and a neurologist according to diagnostic criteria of DSMIV-TR was achieved for every patient. RESULTS: Overall, 90.5% had at least one BPSD symptom. Common symptoms were irritability (60.8%), sleep problems (57%), depression (54.5%), anxiety (52%), and agitation/aggression (44.9%). The least common symptom was eating problems (23.5%). The caregivers rated the patient's physical symptoms as more severe than psychological symptoms. The symptom that caused the highest burden to caregivers was agitation/aggression, followed by dis-inhibition, aberrant motor behaviors, and sleep problems. The less burdensome symptoms included irritability, depression, and anxiety. CONCLUSION: BPSD were commonly found among patients with dementia. The top five symptoms were irritability, sleep problems, depression, anxiety, and agitation/aggression. Not only assessment of BPSD, but also feeling and suffering of the caregivers should be assessed by using the NPI-Q. This would help the clinician plan appropriate treatment. Physical symptoms were perceived by caregivers as causing the most anguish and distress, while psychological symptoms were perceived as less severe. Further studies should be done, such as the factors related to burden of caregivers of dementia with BPSD.