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An inflammatory process is discussed as a causative factor. The aim of this study was to search for changes in various cytokine concentrations in serum and cerebrospinal fluid (CSF) in patients with facial nerve palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, 47 patients with peripheral facial nerve palsy were included. Of these, 40 patients were diagnosed as BP and seven patients as non-idiopathic peripheral facial palsy (nipFP). Seventeen cytokines, including IL-1A, IL-5, IL-9, granulocyte colony-stimulating factor (G-CSF), CXCL-13, granulocyte\u2013macrophage-colony-stimulating factor (GM-CSF), tumor necrosis factor-SF13 (TNFSF13), IL-8, IL-1\u00df, CXCL-10, fractalkine (Fract), monocyte chemotactic protein (MCP-1), IFN-y, IL-4, IL-17A, tumor necrosis factor (TNF), and Granzyme, were measured in the serum and CSF. For comparison, sera from 10 healthy individuals were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In serum, the levels of cytokines G-CSF, CXCL13, TNFSF13, and Granzyme were statistically significantly higher in patients with BP and nipFP compared to healthy individuals (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Cytokine IL-1\u00df was significantly higher in nipFP patients compared to healthy individuals and patients with BP (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Cytokine IL-8 was significantly lower in both patient groups than in healthy individuals (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). In CSF, G-CSF, CXCL13, TNFSF13, IL-8, IL-1\u00df, and IL-17A were statistically significantly higher in patients with nipFP compared to patients with BP (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). In addition, patients with BP also showed a clustering of cytokine elevation. For differentiating nipFP from BP, serum G-CSF and IL1\u00df indicated a certain discrimination (AUC 0.643; 0.614). Patients with severe facial palsy revealed higher CSF TNFSF13 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), and clinical outcome after 3 months was less favorable at higher CSF Fractalkine (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025). Elevated CSF cell count was associated with elevated CXCL13, IL-8, IL-1\u00df, IP-10, IFNa and granzyme in the CSF (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.32\u20130.57;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to healthy individuals, our study revealed an altered cytokine profile in patients with BP that resembles patients with nipFP. In CSF, a subset of cytokines was identified in patients with BP, but higher levels were found in patients with nipFP, suggesting a graduated inflammatory process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study registration<\/jats:title>\n                    <jats:p>The study \"Serum and CSF cytokine profile in patients with facial palsy (Bell\u00b4s palsy)\" has been officially registered at the German Clinical Trials Register (DRKS00037815).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-025-13561-8","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T17:55:36Z","timestamp":1765302936000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Serum and CSF cytokine profile in patients with facial palsy (Bell\u2019s palsy): a pilot study"],"prefix":"10.1007","volume":"273","author":[{"given":"Alexander","family":"Ustinov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9605-8703","authenticated-orcid":false,"given":"Josef Georg","family":"Heckmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borros","family":"Arneth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schwab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"13561_CR1","first-page":"692","volume":"116","author":"JG Heckmann","year":"2019","unstructured":"Heckmann JG, Urban PP, Pitz S, Guntinas-Lichius O, G\u00e1gyor I (2019) The diagnosis and treatment of idiopathic facial paresis (Bell\u2019s palsy). 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