Childhood peripheral facial palsy
The objectives of this study were to evaluate the demographic and clinical characteristics, causes, treatment patterns, outcome, and recurrence of childhood peripheral facial palsy.
We performed a retrospective study of 144 peripheral facial palsy patients, under 18 years old in a tertiary care pediatric hospital. Medical charts were reviewed to analyze the age, gender, side of facial nerve paralysis, family history, cause, grading by the House-Brackmann Facial Nerve Grading Scale (HBS), results of diagnostic tests, therapies, outcomes, and recurrence.
Causes were as follows: 115 idiopathic (Bell’s palsy) facial palsy (79.9%), 17 infections (11.8%) (9 otitis media, 4 varicella zoster virus (VZV) infection, 3 tooth abscess, and 1 group A β-hemolytic streptococcus infection), 7 trauma (4.9%), 4 congenital-syndrome (2.8%), and 1 (0.7%) arterial hypertension. There was no difference in age, sex, family history, grading, or outcome between idiopathic and cause-defined facial palsy. At the end of the first year, our recovery rates were 98.3%. No significant difference in recovery outcome was detected between the patients who were treated with and without steroid treatment. Thirteen (9%) patients had recurrent attacks, and no differences in the outcomes of patients with recurrent facial palsy were observed. Recurrence time ranged from 6 months to 6 years.
The results of this study indicate that both Bell’s palsy and cause-defined facial palsy in children have a very good prognosis. Medical treatment based on corticosteroids is not certainly effective in improving outcomes in children. Recurrent attacks occurred in 6 years from the onset which leads to the conclusion that we should have a long-term follow-up of patients diagnosed with Bell’s palsy.
KeywordsBell’s palsy Facial nerve Outcome Recurrence
This study was completed at the Department of Pediatric Neurology, Ankara Children’s Hematology-Oncology Training and Research Hospital. The authors thank all colleagues for their help in follow-up of the patients.
ZSK and ZO were involved in the diagnosis and follow-up of the patients, collected data, and wrote the whole article. TBK performed the data collection. BDT was involved in writing the article. EG was involved in the diagnosis and follow-up of the patients. AG was involved in developing the project and the revision of the final manuscript.
The authors received no financial support for the research, authorship, and/or publication of this article.
Compliance with ethical standards
Conflict of interest
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
This study was approved by the Hospital Ethical Committee of Health IRB# 2015/048.
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