Facial palsy: etiology, outcome and management in children

Eur J Paediatr Neurol. 2011 May;15(3):209-13. doi: 10.1016/j.ejpn.2010.11.004. Epub 2010 Dec 14.

Abstract

Background: Currently there is much controversy whether to treat idiopathic facial palsy with corticosteroids with sparse data on the natural course of the disease in children.

Methods: We performed a prospective study on all children <15 years of age who were admitted to our unit for facial palsy between 1st July 1998 to 30th June 2008. All patients received a standardized work-up and follow-up. Therapy consisted of symptomatic treatment either with (in case of neuroborreliosis) or without a 14 day course of intravenous antibiotics.

Findings: 106 patients were included in our study. The calculated incidence for facial palsy was 21.1/100000/year for children <15 years. The incidence for neuroborreliosis (NB) in this age group was calculated to be 4.9/100000/year. The overall rate of complete recovery was 97.6% with significantly faster recovery in younger children and in patients with NB as compared to idiopathic facial palsy. Both patients with incomplete recovery were at least 14 years old and presented late in the course of the disease.

Conclusion: Based on the rate of 97.6% spontaneous complete recovery we believe that the routine use of corticosteroids in children with facial palsy is not justified, unless there is new data from controlled trials in children.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Anti-Bacterial Agents / administration & dosage
  • Ceftriaxone / administration & dosage
  • Child
  • Child, Preschool
  • Comorbidity / trends
  • Facial Paralysis / drug therapy*
  • Facial Paralysis / epidemiology
  • Facial Paralysis / etiology*
  • Female
  • Germany / epidemiology
  • Humans
  • Infant
  • Lyme Neuroborreliosis / complications*
  • Lyme Neuroborreliosis / drug therapy*
  • Lyme Neuroborreliosis / epidemiology
  • Male
  • Prospective Studies

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Ceftriaxone