Congenital facial nerve palsy: Single center study

Abstract

ObjectivesThis study will list the most common comorbidities of congenital facial nerve palsy and how to detect and treat them, with special attention for ENT-problems such as hearing loss. Congenital facial nerve palsy is a very rare entity but in UZ Brussels hospital there was a follow-up of 16 children in the last 30 years.MethodsLiterature review has been done, combined with thorough research of our own series of 16 children with congenital facial nerve palsy.ResultsCongenital facial nerve palsy can be part of a known syndrome, most commonly Moebius syndrome, but can also appear solely. It appears often bilateral and with a severe gradation. In our series, hearing loss is frequently seen in association with congenital facial nerve palsy. Other abnormalities are dysfunction of the abducens nerve, ophthalmological problems, retro- or micrognathism and abnormalities of limbs or heart. The majority of the children in our series underwent radiological imaging (CT and/or MRI): the facial nerve but also the vestibulocochlear nerve and middle and inner ear can be evaluated.ConclusionA multidisciplinary approach of congenital facial nerve palsy is recommended as it can affect various bodily functions. Radiological imaging needs to be done to acquire additional information that can be useful for diagnostic and therapeutic purposes. Although congenital facial nerve palsy may not be treatable itself, its comorbidities can be treated and improve the quality of life of the affected child.

An unusual cause of facial nerve palsy affecting a mum and her child with literature review and analysis for other causes

“…Unfortunately, in about 50% of the cases, the aetiology remains unknown: these forms are classified as Bell's palsy. In children, Bell's palsy has an estimated incidence of about 6.1 cases per year per 100,000 in those aged between 1 and 15 years [2][3][4][5]. It is believed that it can be caused by viruses such as Herpes simplex.…”

“…In Möbius syndrome other cranial nerves such as the III, IV, V, and VIII can be involved, which is not the case in our patient. The reported prevalence of this syndrome is about 1/150,000 live births [1,2,4,8]. It is reported to be due to hypoplasia of the motor nuclei of the cranial nerve/s within the brainstem, probably due to hypoxic-ischemic encephalopathy.…”

“…These can be classified as congenital related to birth trauma, syndromic and non-syndromic malformations and genetic. Or acquired caused by infectious, inflammatory, neoplastic, traumatic conditions [1,2,3], [Table 1]. However, significant numbers of Pediatrics facial nerve palsy remain unknown.…”

“…For example a gradual onset for > 3 weeks may suggest a possibility of a neoplastic etiology. All the associated symptoms should be identified, as well as any other comorbidities affecting the child [1][2][3][4][5].…”

“…Electrophysiological studies can be useful to identify the cause of the paralysis and to define the prognosis and follow-up of functional recovery, but they are still not considered necessary in all pediatric patients [1][2][3][4][5][6].…”