Low-Level Laser Therapy in Pediatric Bell's Palsy: Case Report in a Three-Year-Old Child

Abstract

Objectives: The objective of this study was to apply low-level laser therapy (LLLT) to accelerate the recovery process of a child patient with Bell's palsy (BP). Design: This was a prospective study. Subject: The subject was a three-year-old boy with a sudden onset of facial asymmetry due to an unknown cause. Materials and methods: The low-level laser source used was a gallium aluminum arsenide semiconductor diode laser device (660 nm and 780 nm). No steroids or other medications were given to the child. The laser beam with a 0.04-cm 2 spot area, and an aperture with approximately 1-mm diameter, was applied in a continuous emission mode in direct contact with the facial area. The duration of a laser session was between 15 and 30 minutes, depending on the chosen points and the area being treated. Light was applied 10 seconds per point on a maximum number of 80 points, when the entire affected (right) side of the face was irradiated, based on the small laser beam spot size. According to the acupuncture literature, this treatment could also be carried out using 10-20 Chinese acupuncture points, located unilaterally on the face. In this case study, more points were used because the entire affected side of the face (a large area) was irradiated instead of using acupuncture points. Outcome measures: The House-Brackmann grading system was used to monitor the evolution of facial nerve motor function. Photographs were taken after every session, always using the same camera and the same magnitude. The three-year-old boy recovered completely from BP after 11 sessions of LLLT. There were 4 sessions a week for the first 2 weeks, and the total treatment time was 3 weeks. Results: The result of this study was the improvement of facial movement and facial symmetry, with complete reestablishment to normality. Conclusions: LLLT may be an alternative to speed up facial normality in pediatric BP.

Bell's palsy treated with photobiomodulation in an adolescent: Rare case report and review of the published literature

“…Photobiomodulation has been shown as an effective alternative therapy for BP treatment, especially for children and those who cannot take drugs, such as diabetic and hypertensive patients. There is no consensus on the use of corticosteroids for the treatment of BP in the pediatric population; consonantly, laser therapy presents no side effects, significantly faster clinical improvement, also being a true noninvasive approach, which facilitates its use in pediatric patients.…”

“…Few studies have been published about the use of PBM for the treatment of facial paralysis and only one of them describes its use in a child (Table ). Infrared laser was the most commonly used, which makes sense due to aiming for deeper light penetration for deeper tissues (nerve fibers), including the present case.…”

“…Bell's palsy (BP) is represented by the paralysis of the seventh cranial nerve on one side of the face, leading to weakness of facial muscles that can result on facial expression loss causing difficulties in social relationships and loss of quality of life . BP is the most common cause of the peripheral unilateral facial nerve paralysis, being an acute, idiopathic disorder, which exact mechanism is unknown but considered to be a result of facial nerve inflammation or infection . In fact, evidences suggest that BP may be caused by reactivation of latent herpes simplex virus type 1 …”

“…BP has an estimated annual incidence of 25 cases per 100 000, comprising 60%‐75% of cases of acute unilateral facial paralysis . About 70% of the patients have a spontaneous complete recovery …”

“…There are few published reports on the treatment of BP using PBM, though. But since PBM presents such significant benefits for BP, also being a noninvasive intervention lacking side effects, especially for pediatric use, it deserves to be further explored.…”