Do Oral Steroids Aid Recovery in Children With Bell's Palsy?

Abstract

There is growing evidence that steroids are not beneficial for treatment of paediatric patients with Bell's palsy. To investigate, we conducted a retrospective longitudinal study examining notes of 100 children, over 12 years coded for facial nerve palsy. Of the 79 diagnosed with Bell's palsy, all recovered, and for 46 patients we had data on interval from onset of symptoms to resolution (median duration in treated group = 5 weeks, range = 39; median duration in untreated group = 6 weeks, range = 11; P = .86). From our results, we conclude that all children with Bell's palsy recovered, with or without steroid treatment, with no statistically significant difference in symptoms duration. Complications of unresolved Bell's palsy can have important long-term functional and psychosocial consequences. Therefore, we need further research on use of steroids in children with complete/severe cases; it would be a shame to omit treatment due to "absence of evidence" rather than "evidence of absence."

Peripheral facial nerve palsy in children in a Borrelia high‐endemic area, a retrospective follow‐up study

“…No formal consensus regarding treatment with prednisolone exists due to a lack of randomised controlled trials and differences in opinion on the matter . In the current study, 53% of all children ≥10 years of age were treated with oral steroids.…”

“…19 Of the six children in our study with partial regress of symptoms, No formal consensus regarding treatment with prednisolone exists due to a lack of randomised controlled trials and differences in opinion on the matter. [20][21][22] In the current study, 53% of all children ≥10 years of age were treated with oral steroids. While our study does not offer the possibility of any significant conclusions on the efficacy of cortisone treatment, it highlights the current ambivalence in the clinical settings and the need for clinical guidelines.…”

Heterotaxy syndrome with complex congenital heart disease, facial palsy, and asplenia: A rare newborn finding

“…As, majority of children with facial palsy have a good prognosis with or without treatment (steroids, antivirals) and absence of sequela. 24 The severity of congenital heart disease is associated with the prognosis of ambiguous in children. 25 Patients with complex cardiac lesions and heterotaxy have a poor prognosis with 1‐year mortality >85% in patients with asplenia and >50% in patients with polysplenia.…”

“…In regard to the management of facial palsy in our case due to perinatal trauma(congenital), the family members were well counseled about the favorable prognosis of facial palsy. As, majority of children with facial palsy have a good prognosis with or without treatment (steroids, antivirals) and absence of sequela 24 . The severity of congenital heart disease is associated with the prognosis of ambiguous in children 25 .…”

Acute Facial Nerve Palsy in Children: Gold Standard Management

“…Thus, on children, if corticosteroids are used, it is recommended to begin preferably within 3 days (up to 7 days) from onset of symptoms [ 36 ]. The recommendation is to start oral prednisolone at a dose of 1 to 2 mg/kg/day (maximum dose 60 mg) for 5 to 7 days, and then stop [ 10 , 36 , 42 ]. However, regarding administration of corticosteroids and their dosing regimens, caution should be used in patients with diabetes mellitus, hypertension, renal or hepatic dysfunction or an underlying immunocompromised state [ 43 ].…”