{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T13:44:39Z","timestamp":1792935879737,"version":"4.5.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230293-4\"><jats:title>Importance<\/jats:title><jats:p>There is no consensus on the benefits of routine magnetic resonance imaging (MRI) of the facial nerve in patients with suspected idiopathic peripheral facial palsy (PFP) (ie, Bell palsy [BP]).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230293-5\"><jats:title>Objectives<\/jats:title><jats:p>To estimate the proportion of adult patients in whom MRI led to correction of an initial clinical diagnosis of BP; to determine the proportion of patients with confirmed BP who had MRI evidence of facial nerve neuritis without secondary lesions; and to identify factors associated with secondary (nonidiopathic) PFP at initial presentation and 1 month later.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230293-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective multicenter cohort study analyzed the clinical and radiological data of 120 patients initially diagnosed with suspected BP from January 1, 2018, to April 30, 2022, at the emergency department of 3 tertiary referral centers in France.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230293-7\"><jats:title>Interventions<\/jats:title><jats:p>All patients screened for clinically suspected BP underwent an MRI of the entire facial nerve with a double-blind reading of all images.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230293-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The proportion of patients in whom MRI led to a correction of the initial diagnosis of BP (any condition other than BP, including potentially life-threating conditions) and results of contrast enhancement of the facial nerve were described.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230293-9\"><jats:title>Results<\/jats:title><jats:p>Among the 120 patients initially diagnosed with suspected BP, 64 (53.3%) were men, and the mean (SD) age was 51 (18) years. Magnetic resonance imaging of the facial nerve led to a correction of the diagnosis in 8 patients (6.7%); among them, potentially life-threatening conditions that required changes in treatment were identified in 3 (37.5%). The MRI confirmed the diagnosis of BP in 112 patients (93.3%), among whom 106 (94.6%) showed evidence of facial nerve neuritis on the affected side (hypersignal on gadolinium-enhanced T1-weighted images). This was the only objective sign confirming the idiopathic nature of PFP.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230293-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These preliminary results suggest the added value of the routine use of facial nerve MRI in suspected cases of BP. Multicentered international prospective studies should be organized to confirm these results.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.9158","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T16:34:38Z","timestamp":1682008478000},"page":"e239158","source":"Crossref","is-referenced-by-count":17,"title":["Incidence of Underlying Abnormal Findings on Routine Magnetic Resonance Imaging for Bell Palsy"],"prefix":"10.1001","volume":"6","author":[{"given":"Thibault","family":"Savary","sequence":"first","affiliation":[{"name":"Service d\u2019ORL, d\u2019Otoneurochirurgie et de Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Fieux","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL, d\u2019Otoneurochirurgie et de Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"},{"name":"Universit\u00e9 de Lyon, Universit\u00e9 Lyon 1, Lyon, France"},{"name":"Universit\u00e9 Paris Est Cr\u00e9teil, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Mondor Institute for Biomedical Research (IMRB), Cr\u00e9teil, France"},{"name":"Centre National de la Recherche Scienti\ufb01que (CNRS) Equipe Mixte de Recherche 7000, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Douplat","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lyon, Universit\u00e9 Lyon 1, Lyon, France"},{"name":"Service des Urgences, Hospices Civils of Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"},{"name":"Research on Healthcare Performance, Universit\u00e9 Claude Bernard Lyon 1, INSERM U1290, Lyon, France."},{"name":"Unit\u00e9 Mixte de Recherche (UMR) Ad\u00e9s 7268, Aix-Marseille University, Etablissement Fran\u00e7ais du Sang\u2013CNRS, Espace \u00c9thique M\u00e9diterran\u00e9en, Marseille, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Tournegros","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL, d\u2019Otoneurochirurgie et de Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Daubie","sequence":"additional","affiliation":[{"name":"Service d\u2019Imagerie M\u00e9dicale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Pavie","sequence":"additional","affiliation":[{"name":"Service d\u2019Imagerie M\u00e9dicale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna","family":"Denoix","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL, d\u2019Otoneurochirurgie et de Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Baptiste","family":"Pialat","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lyon, Universit\u00e9 Lyon 1, Lyon, France"},{"name":"Service d\u2019Imagerie M\u00e9dicale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"},{"name":"Creatis CNRS UMR 5220, INSERM U1294, Universit\u00e9 Lyon 1, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Tringali","sequence":"additional","affiliation":[{"name":"Service d\u2019ORL, d\u2019Otoneurochirurgie et de Chirurgie Cervico-Faciale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre B\u00e9nite, France"},{"name":"Universit\u00e9 de Lyon, Universit\u00e9 Lyon 1, Lyon, France"},{"name":"UMR 5305, Laboratoire de Biologie Tissulaire et d\u2019Ing\u00e9nierie Th\u00e9rapeutique, Institut de Biologie et Chimie des Prot\u00e9ines, CNRS Universit\u00e9 Claude Bernard Lyon 1, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"issue":"5","key":"zoi230293r1","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1159\/000065645","article-title":"Annualized incidence and spectrum of illness from an outbreak investigation of Bell\u2019s palsy.","volume":"21","author":"Morris","year":"2002","journal-title":"Neuroepidemiology"},{"issue":"549","key":"zoi230293r2","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1080\/000164802760370736","article-title":"Bell\u2019s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies.","volume":"122","author":"Peitersen","year":"2002","journal-title":"Acta Otolaryngol Suppl"},{"issue":"7757","key":"zoi230293r3","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1016\/S0140-6736(72)91499-7","article-title":"Herpes-simplex virus as a cause of Bell\u2019s palsy.","volume":"1","author":"McCormick","year":"1972","journal-title":"Lancet"},{"issue":"6","key":"zoi230293r4","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.anorl.2020.06.004","article-title":"French Society of ENT (SFORL) guidelines: management of acute Bell\u2019s palsy.","volume":"137","author":"Fieux","year":"2020","journal-title":"Eur Ann Otorhinolaryngol Head Neck Dis"},{"issue":"986","key":"zoi230293r5","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1259\/bjr\/70067143","article-title":"Enhancement pattern of the normal facial nerve at 3.0 T temporal MRI.","volume":"83","author":"Hong","year":"2010","journal-title":"Br J Radiol"},{"issue":"2","key":"zoi230293r6","first-page":"81","article-title":"Magnetic resonance imaging in facial Bell\u2019s palsy [in French].","volume":"119","author":"Belv\u00e8ze","year":"2002","journal-title":"Ann Otolaryngol Chir Cervicofac"},{"issue":"11","key":"zoi230293r7","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1053\/crad.2001.0730","article-title":"Facial nerve palsy: evaluation by contrast-enhanced MR imaging.","volume":"56","author":"Kinoshita","year":"2001","journal-title":"Clin Radiol"},{"issue":"7","key":"zoi230293r8","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1002\/ccr3.v8.7","article-title":"Misdiagnosis of Bell\u2019s palsy: case series and literature review.","volume":"8","author":"Bacorn","year":"2020","journal-title":"Clin Case Rep"},{"issue":"5","key":"zoi230293r9","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1177\/0194599813506835","article-title":"Clinical practice guideline: Bell\u2019s palsy executive summary.","volume":"149","author":"Baugh","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"12","key":"zoi230293r10","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1503\/cmaj.131801","article-title":"Management of Bell palsy: clinical practice guideline.","volume":"186","author":"de Almeida","year":"2014","journal-title":"CMAJ"},{"issue":"20","key":"zoi230293r11","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.","volume":"310","author":"World Medical Association","year":"2013","journal-title":"JAMA"},{"issue":"4","key":"zoi230293r12","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.annemergmed.2013.06.022","article-title":"Potential misdiagnoses of Bell\u2019s palsy in the emergency department.","volume":"63","author":"Fahimi","year":"2014","journal-title":"Ann Emerg Med"},{"issue":"10","key":"zoi230293r13","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.1007\/s00415-019-09387-w","article-title":"Differential diagnosis of peripheral facial nerve palsy: a retrospective clinical, MRI and CSF-based study.","volume":"266","author":"Zimmermann","year":"2019","journal-title":"J Neurol"},{"key":"zoi230293r14","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/248039","article-title":"Imaging the facial nerve: a contemporary review.","volume":"2013","author":"Gupta","year":"2013","journal-title":"Radiol Res Pract"},{"key":"zoi230293r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101456","article-title":"Clinical and radiological findings of facial paralysis in multiple sclerosis.","volume":"37","author":"Di Stadio","year":"2020","journal-title":"Mult Scler Relat Disord"},{"issue":"10","key":"zoi230293r16","doi-asserted-by":"publisher","first-page":"5328","DOI":"10.1007\/s00415-022-11189-6","article-title":"Facial nerve palsy in neurosarcoidosis: clinical course, neuroinflammatory accompaniments, ancillary investigations, and response to treatment.","volume":"269","author":"Nwebube","year":"2022","journal-title":"J Neurol"},{"issue":"2","key":"zoi230293r17","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1177\/0194599820913639","article-title":"Facial schwannoma management outcomes: a systematic review of the literature.","volume":"163","author":"Bartindale","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"9","key":"zoi230293r18","doi-asserted-by":"publisher","first-page":"3359","DOI":"10.1007\/s00405-017-4665-x","article-title":"A retrospective study on facial nerve schwannomas: a disease with a high risk of misdiagnosis and hearing loss.","volume":"274","author":"Li","year":"2017","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"1","key":"zoi230293r19","first-page":"1","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation.","volume":"40","author":"Matthies","year":"1997","journal-title":"Neurosurgery"},{"issue":"10","key":"zoi230293r20","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1097\/MAO.0000000000000891","article-title":"Management of geniculate ganglion hemangiomas: case series and systematic review of the literature.","volume":"36","author":"Oldenburg","year":"2015","journal-title":"Otol Neurotol"},{"issue":"5","key":"zoi230293r21","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.amjoto.2009.04.003","article-title":"When the bell tolls on Bell\u2019s palsy: finding occult malignancy in acute-onset facial paralysis.","volume":"31","author":"Quesnel","year":"2010","journal-title":"Am J Otolaryngol"},{"issue":"4","key":"zoi230293r22","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1016\/j.clineuro.2007.12.005","article-title":"Isolated nuclear facial palsy, a rare variant of pure motor lacunar stroke.","volume":"110","author":"Novy","year":"2008","journal-title":"Clin Neurol Neurosurg"},{"issue":"1","key":"zoi230293r23","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12883-019-1440-1","article-title":"Patterns of pontine strokes mimicking Bell\u2019s palsy.","volume":"19","author":"Min","year":"2019","journal-title":"BMC Neurol"},{"issue":"3","key":"zoi230293r24","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/bjhp.v25.3","article-title":"The psychosocial impact of facial palsy: a systematic review.","volume":"25","author":"Hotton","year":"2020","journal-title":"Br J Health Psychol"},{"issue":"1","key":"zoi230293r25","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1002\/ca.22311","article-title":"3T MRI and 128-slice dual-source CT cisternography images of the cranial nerves a brief pictorial review for clinicians.","volume":"27","author":"Roldan-Valadez","year":"2014","journal-title":"Clin Anat"},{"issue":"4","key":"zoi230293r26","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1136\/jnnp.2007.118489","article-title":"The usefulness of clinical findings in localising lesions in Bell\u2019s palsy: comparison with MRI.","volume":"79","author":"Seok","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"zoi230293r27","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3109\/00016489409128325","article-title":"Facial nerve enhancement in Gd-MRI in patients with Bell\u2019s palsy.","volume":"511","author":"Kohsyu","year":"1994","journal-title":"Acta Otolaryngol Suppl"},{"issue":"9","key":"zoi230293r28","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1177\/0003489419848462","article-title":"Determining etiology of facial nerve paralysis with MRI: challenges in malignancy detection.","volume":"128","author":"Tolisano","year":"2019","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"9","key":"zoi230293r29","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1177\/0284185120958414","article-title":"Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in Bell\u2019s palsy.","volume":"62","author":"Wang","year":"2021","journal-title":"Acta Radiol"},{"issue":"5","key":"zoi230293r30","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.v75.5","article-title":"Evaluation of Bell\u2019s palsy in the cerebellopontine angle: an MRI study.","volume":"75","author":"Erdogan","year":"2021","journal-title":"Int J Clin Pract"},{"issue":"10","key":"zoi230293r31","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1097\/MAO.0000000000001605","article-title":"Usefulness of high-resolution 3D multi-sequences for peripheral facial palsy: differentiation between Bell\u2019s palsy and Ramsay Hunt syndrome.","volume":"38","author":"Kuya","year":"2017","journal-title":"Otol Neurotol"},{"issue":"17","key":"zoi230293r32","doi-asserted-by":"publisher","first-page":"3914","DOI":"10.3390\/jcm10173914","article-title":"Association between initial severity of facial weakness and outcomes of Bell\u2019s palsy.","volume":"10","author":"Yoo","year":"2021","journal-title":"J Clin Med"},{"issue":"1","key":"zoi230293r33","doi-asserted-by":"publisher","first-page":"23387","DOI":"10.1038\/s41598-021-02816-9","article-title":"Risk factors for Bell\u2019s palsy based on the Korean National Health Insurance Service National Sample Cohort data.","volume":"11","author":"Jeong","year":"2021","journal-title":"Sci Rep"},{"issue":"3","key":"zoi230293r34","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1023\/A:1006254518848","article-title":"Glucocorticoid treatment of primary CNS lymphoma.","volume":"43","author":"Weller","year":"1999","journal-title":"J Neurooncol"},{"issue":"16","key":"zoi230293r35","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1056\/NEJMoa072006","article-title":"Early treatment with prednisolone or acyclovir in Bell\u2019s palsy.","volume":"357","author":"Sullivan","year":"2007","journal-title":"N Engl J Med"},{"key":"zoi230293r36","first-page":"1204","article-title":"Bell\u2019s palsy.","volume":"2014","author":"Holland","year":"2014","journal-title":"BMJ Clin Evid"},{"issue":"21","key":"zoi230293r37","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1001\/archinte.164.21.2383","article-title":"The spectrum of cranial neuropathy in patients with Bell\u2019s palsy.","volume":"164","author":"Benatar","year":"2004","journal-title":"Arch Intern Med"},{"issue":"1","key":"zoi230293r38","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s00405-017-4816-0","article-title":"Prevalence and characteristics of hearing loss in patients diagnosed with Bell\u2019s palsy.","volume":"275","author":"Maller","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2803956\/savary_2023_oi_230293_1681223818.12062.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T16:34:45Z","timestamp":1682008485000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2803956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.9158","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]}}}