000K utf8 1100 2025$c2025-08-21 1500 eng 2050 urn:nbn:de:gbv:27-dbt-67749-3 2051 10.1111/ene.70336 3000 Neckel, Norbert 3010 Audebert, Heinrich 3010 Guntinas‐Lichius, Orlando 3010 Heiland, Max 3010 Nahles, Susanne 3010 Preissner, Robert 3010 Preissner, Saskia 3010 Zdunczyk, Anna 4000 Risk Factors Associated With Bell's Palsy: A Real‐World Analysis of 281,600 Patients [Neckel, Norbert] 4060 7 Seiten 4209 Introduction Bell's palsy is the most common cause of peripheral facial paralysis, with an annual incidence of 5–50 per 100,000 cases worldwide. Its etiology remains largely unknown, though risk factors such as herpes simplex virus reactivation, diabetes, depression, and pregnancy‐related complications have been suggested. Understanding these risk factors is critical for improving diagnosis, prevention, and treatment strategies. Methods A retrospective analysis of the TriNetX database included over 25 million patients. Two cohorts of approximately 140,800 patients each, matched for age and sex, were analyzed for associations between BP and herpes simplex virus, diabetes, depression, and pregnancy. Odds ratios (OR) and confidence intervals (CI) were calculated, with p  < 0.05 indicating significance. Results Herpes simplex virus showed the strongest association with Bell's palsy (OR: 6.49, 95% CI: 5.96–7.05); followed by diabetes (OR: 2.4, CI: 2.36–2.46) and depression (OR: 2.05, CI: 2.0–2.1). Pregnancy was inversely correlated (OR: 0.76, CI: 0.73–0.78). Conclusion Herpes simplex virus reactivation appears to be a major risk factor, suggesting a potential role of antiviral therapies in select cases. The associations with diabetes and depression highlight a need for metabolic and mental health evaluations in patients with Bell's palsy. The inverse correlation with pregnancy warrants further investigation into pregnancy‐related conditions. These findings emphasize the multifactorial nature of this condition and the importance of individualized approaches to reduce its idiopathic classification. This study analyzed over 280,000 patient records to identify key risk factors associated with Bell's palsy. The strongest association was found with herpes simplex virus reactivation, followed by diabetes and depression, while pregnancy showed an inverse correlation. These findings highlight the multifactorial nature of Bell's palsy and support more individualized diagnostic and treatment approaches. 4950 https://doi.org/10.1111/ene.70336$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:gbv:27-dbt-67749-3$xR$3Volltext$534 4961 https://www.db-thueringen.de/receive/dbt_mods_00067749 5051 610 5550 Bell's palsy 5550 depression 5550 herpes 5550 pregnancy 5550 risk factors