Title:Acute Peripheral Facial Nerve Palsy in Children and Adolescents:
Clinical Aspects and Treatment Modalities
Volume: 22
Issue: 9
Author(s): Jasna Jančić, Janko Zeković, Mila Ćetković, Blažo Nikolić, Nikola Ivančević, Danijela Vučević, Zorica Nešić, Srđan Milovanović, Miroslav Radenković and Janko Samardžić*
Affiliation:
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade,
Serbia
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade,
Belgrade 11000, Serbia
Keywords:
Peripheral facial nerve palsy, bell’s palsy, house-brackmann scale, clinical characteristics, children, adolescents, inpatients, outpatients.
Abstract:
Background: Peripheral facial nerve palsy is a relatively frequent, rather idiopathic, and
isolated nonprogressive disorder with a tendency toward spontaneous recovery in children. It is primarily
characterized by unilateral paresis or paralysis of the mimic musculature, affecting verbal
communication, social interactions, and quality of life.
Objective: This study aimed to evaluate the clinical aspects and efficacy of different therapeutic modalities
in the population of children and adolescents with acute peripheral facial nerve palsy, the quality
and recovery rate in comparison to different therapy modalities and etiological factors as well as to
determine parameters of recovery according to the age of patients.
Methods: The retrospective study included children and adolescents (n=129) with an acute onset of
peripheral facial nerve palsy, diagnosed and treated in the Clinic of Neurology and Psychiatry for
Children and Youth in Belgrade (2000-2018). The mean age of the patients was 11.53 years
(SD±4.41). Gender distribution was 56.6% female and 43.4% male patients.
Results: There were 118 (91.5%) patients with partial and 11 (8.5%) patients with complete paralysis.
Left-sided palsy occurred in 67 (51.9%) patients, right-sided in 58 (45.0%), while there were 4 (3.1%)
bilateral paralyses. The most common etiological factor was idiopathic (Bell’s palsy), i.e., 74 (57.4%)
patients, followed by middle ear infections, i.e., 16 (12.4%). Regardless of etiology, age, and therapy
protocols, there was a significant recovery in most of the patients (p<0.001), without significant differences
in recovery rate. Comparison of inpatient and outpatient populations showed significant differences
regarding the number of relapses, the severity of clinical presentation, and the recovery rate in
relation to etiology.
Conclusion: Bell’s palsy is shown to be the most common cause of peripheral facial nerve palsy in
children and adolescents, regardless of gender. It is followed by mid-ear infections, respiratory infections,
and exposure to cold. Most children and adolescents recovered three weeks after initial presentation,
regardless of etiology, age, and therapy.
