Facial paralysis in childhood hypertension

Bell's palsy: A guideline proposal following a review of practice

“…Bell's palsy is a diagnosis of exclusion, and many publications concentrate on the management of the condition once diagnosis has been made, paying little attention to the importance of excluding other causes of facial palsy. Hypertension for example, has been shown to be associated with a facial palsy in about 2.5% of presentations in paediatrics 5 . Other causes such as cholesteatoma, infectious mononucleosis, leukaemia, stroke and acute disseminated encephalomyelitis, should be considered 6…”

Peripheral Facial Nerve Palsy in Severe Systemic Hypertension: A Systematic Review

“…In total, 18 reports were included in this study (17 in English, one in Italian) describing 24 cases. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] All publications included were reports of single cases or case series.…”

“…In these cases, facial palsy occurred when BP was not well controlled (nonadherence of antihypertensive treatment) and severe hypertension exacerbated. 5,8,12 The etiology of arterial hypertension was established in 19 patients, consisting of congenital anomalies of the kidney and urinary tract, 6,17,[20][21] aortic coarctation, 13,[15][16] renal artery stenosis, 8,18 renal adenocarcinoma, 10 and pheochromocytoma 7 (Table 1). In the three children with Guillain-Barré syndrome, 11,19 both isolated peripheral facial nerve palsy and severe systemic hypertension were the presenting signs before further features of the polyneuropathy were apparent.…”

“…Neuroimaging was described in 11 patients, nine of whom were children (Table 1). [5][6][8][9]15,[17][18][19][20] Computed tomography was performed in two and magnetic resonance imaging (MRI) in nine patients. Cerebral MRI revealed a pontine hemorrhage at the site of the facial nucleus in a 9-year-old girl, 6 and an ischemic stroke in the dorsal pons affecting the post-nuclear facial fibers in a 47-year-old man.…”

“…19 In three patients, one of whom had a computed tomography, neuroimaging was normal (Table 1). 15,20 No electrophysiological findings specifically addressing the facial nerve were reported.…”