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.
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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