Peripheral facial nerve palsy in children: clinical manifestations, treatment and prognosis

Abstract

Background Sudden onset of unilateral weakness of the upper and lower muscles of one side of the face is defined as peripheral facial nerve palsy. Peripheral facial nerve palsy is often idiopathic and sometimes it could be due to infectious, traumatic, neoplastic, and immune causes. This study aimed to report the clinical manifestation, evaluation, and prognosis in children with peripheral facial nerve palsy. Methods 57 children under 18 years of age diagnosed with peripheral facial nerve palsy at Çukurova University, Balcalı Hospital, between January 2018 and September 2021, were included in the study. Results The mean age of the children at the time of diagnosis was 9.6 ± 7, 4 years. Thirty-two (56.1%) of the patients were female and 25 (43.9%) were male. A total of 57 patients were diagnosed with peripheral facial nerve palsy and categorized into many groups by etiology: idiopathic Bell’s palsy in 27 (47.5%), infectious in 11 (19.2%), traumatic in 6 (10.5%), and others (due to congenital, immune, neoplastic, Melkersson–Rosenthal syndrome, drug toxicity, and iatrogenic causes) in 13 (22.8%). Forty-six of the children achieved full recovery under oral steroids within 1–7 months. Four patients with acute leukemia, myelodysplastic syndrome, Mobius syndrome and trauma did not recover and two patients (schwannoma, trauma) showed partial improvement. Five patients could not come to follow-up control. Conclusion Peripheral facial nerve palsy is a rare condition in children with different causes. It could be idiopathic, congenital, or due to infectious, traumatic, neoplastic, and immune reasons. So, when a child presents with facial palsy, a complete clinical history and a detailed clinical examination are recommended. Giving attention to the red flag is very important. Peripheral facial nerve palsy in children is considered to have a good prognosis.

Bell's palsy in a seven-month-old twin infant: a case report

“…There are still no consistent data confirming the benefit of using corticosteroids alone or associated with an antiviral for the treatment of BP in children. The discussion is based on the complete resolution that children present regardless of whether they use corticosteroids or not [14].…”

A Clinical Case of Delayed Facial Nerve Suitation after Its Damage During Excision of a Dermoid Cyst of the Paratious Region in a Child

“…Паралич лицевого нерва встречается относительно редко и поражает примерно 15-40 человек на 100 000 взрослых ежегодно. Встречается в 2-4 раза реже у детей, чем у взрослых [2]. Заболеваемость детей в возрасте до 10 лет -2,7 случая на 100 000 в год, а у детей старше 10 лет -10,1 случая на 100 000 в год [3,4].…”

“…В клинической практике степени дисфункции VII нерва принято разделять по шкале House -Brackmann (I-VI степени), где I степень -норма, VI степень -полное отсутствие движений мимической мускулатуры. Также немаловажным аспектом является проведение топической диагностики с определением уровня поражения лицевого нерва на протяжении от мостомозжечкового угла до гусиной лапки на шее, что можно осуществить по совокупности клинической картины (сухость глаза или слезотечение, нормальное восприятие звуков или гиперакузия, нормальная вкусовая чувствительность или нарушенная) и данных лучевой диагностики [2]. Понимание уровня поражения лицевого нерва определяет дальнейшую тактику лечения, включающую в себя выбор хирургического доступа и объема операции.…”

Peripheral congenital facial palsy: a rare case report

“…This is due to the rapid onset of symptoms, which can have a significant impact on facial expression, vision, eating, drinking, psychological wellbeing, self-esteem, and quality of life (QoL) (Renault and Quijano-Roy, 2015). The onset is acute and presents with unilateral weakness or paralysis of the facial muscles (upper and lower) due to dysfunction of the peripheral facial nerve on one side of the face (Bilge et al, 2022;Iacono et al, 2022). The prevalence of this disease in the pediatric population is estimated to range from 8% to 25%.…”

“…Therefore, it is essential that a careful and accurate physical examination is conducted to determine if the condition is isolated or part of a syndrome. In addition, the peripheral type of this condition is typically the result of idiopathic causes, including infection, trauma, neoplasm, and immune disorder (Bilge et al, 2022). Consequently, it is commonly referred to as Bell's palsy, which is the most common neurological disorder in children (Khair and Ibrahim, 2018).…”