Clinical Characteristics and Prognosis of Facial Nerve Palsy in Children

Abstract

Purpose: This study was designed to identify the clinical characteristics and prognosis of facial nerve palsy in children, and to determine the different characteristics of the facial nerve palsy patients without underlying condition as opposed to the patients with leukemia, which will help to predict the prognosis and to help treat them. Methods: We investigated 53 patients under 18 years old retrospectively who were diagnosed as facial nerve palsy at the pediatric neurology department of Seoul St. Mary's Hospital from January 2009 to January 2015, and 5 patients with leukemia were included. The degree of nerve damage in a facial nerve palsy patients was determined according to House-Brackmann score. Results: More than 90% of the patients without underlying condition showed grade III and grade IV in the degree of facial nerve damage, meanwhile all of the leukemia patients had grade IV. The location of lesion in more than 90% of the facial nerve palsy patients was under stylomastoid foramen that is the end of the facial nerve. After oral prednisone therapy, 30(69.8%) of 43 patients without underlying condition showed a complete recovery, 11(25.6%) showed little remaining of palsy but was able to conduct 80% of the normal function, which is grade II. In 5 leukemia patients, 2 (40%) showed complete recovery, but 3 patients showed grade II, III and IV, respectively. Conclusion: In children with facial nerve palsy, the location of lesion is usually under stylomastoid foramen, and the degree of palsy is mild so we can predict good outcome. In treatment with oral prednisone, we can expect more than 90% of effectiveness in patients without underlying condition, but only half in leukemia patients.