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Yogeeta F, Devi M, Abdul Rauf S, Rajper SB. Uncommon Bilateral Idiopathic Facial Nerve Palsy (Bell's Palsy) in an Infant: An Atypical Age and Clinical Challenges Explored: A Case Report. EAR, NOSE & THROAT JOURNAL 2024:1455613241258650. [PMID: 38804657 DOI: 10.1177/01455613241258650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Our case study explores Bell's palsy, a rare lower motor neuron facial nerve paralysis, particularly rare in newborns. While often idiopathic, it can stem from congenital or developmental factors. Unilateral facial paralysis is more prevalent, with Bell's palsy accounting for more than 50%, while bilateral facial paralysis is exceptionally rare. We present a distinctive case of idiopathic Bell palsy in a 3.5-month-old infant, initially affecting the right side and spontaneously resolved within 30 days, followed by involvement on the left side a month later. Despite comprehensive evaluations and treatment, persistent facial weakness was observed on the left side. The patient initially responded well but faced ongoing challenges during the second attack. Our findings underscore the need for further research to improve the understanding and management of these cases.
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Affiliation(s)
- Fnu Yogeeta
- Liaquat National Medical College, Karachi, Pakistan
| | - Muskan Devi
- Liaquat National Medical College, Karachi, Pakistan
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Hadford SP, Genther DJ, Byrne PJ. Pediatric Facial Reanimation. Facial Plast Surg Clin North Am 2024; 32:169-180. [PMID: 37981412 DOI: 10.1016/j.fsc.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Pediatric facial palsy is rare but severely debilitating and results in profound functional, developmental, psychosocial, and esthetic consequences. Identifying the specific cause of the palsy is important in directing the treatment course. The most common etiologies of pediatric facial palsy are distinct from those of adults. Facial reanimation interventions are targeted to address the zones of the face, with oral/smile rehabilitation the most common region requiring intervention in pediatric patients. Gracilis microneurovascular free tissue transfer is safe and highly effective in the pediatric population, providing significant functional, psychosocial, and esthetic benefits.
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Affiliation(s)
- Stephen P Hadford
- Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue A71, Cleveland, OH 44195, USA
| | - Dane J Genther
- Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue A71, Cleveland, OH 44195, USA; Section of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue A71, Cleveland, OH 44195, USA
| | - Patrick J Byrne
- Section of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue A71, Cleveland, OH 44195, USA; Chair, Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue A71, Cleveland, OH 44195, USA; Chief, Cleveland Clinic Integrated Surgical Institute, Cleveland, OH 44195, USA.
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Bhate M, Das AV, Singh S. Characteristics of facial nerve palsy in 112 children and risk factors for ocular complications. J AAPOS 2023; 27:141.e1-141.e5. [PMID: 37156335 DOI: 10.1016/j.jaapos.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/28/2023] [Accepted: 03/18/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE To report the ophthalmic findings and ocular complications in a large cohort of pediatric patients with facial nerve palsy (FNP). METHODS Ocular data of children (≤16 years of age) diagnosed with FNP presenting to an eye care network from 2012 to 2021 were analyzed. Study parameters were etiology of FNP, ocular and imaging findings, degree of lagophthalmos, and degree of vision loss. Clinical characteristics were compared between those with and without moderate-to-severe vision impairment (best-corrected visual acuity <20/50) and those with and without exposure keratopathy at presentation. RESULTS A total of 112 patients were included. Mean age at presentation was 8.3 ± 5.0 years. The most common etiology was idiopathic (57%) followed by congenital (22.3%) and traumatic (13.4%). There was bilateral involvement in 8% of children, multiple cranial nerve involvement in 15.2%, and exposure keratopathy at presentation in 38.4%. One-fifth (20.5%) of children (29.6% of affected eyes with known visual acuity) had moderate-to-severe visual impairment. Multiple cranial nerve involvement was present in 31% of eyes with visual impairment compared with 14% of those without. Corneal scarring and strabismic amblyopia were both frequent causes of visual impairment. Most children with exposure keratopathy had lagophthalmos (76.6%), whereas it was less common in those without keratopathy (49.2%). CONCLUSIONS Pediatric FNP was most commonly idiopathic, secondarily congenital. Strabismic amblyopia and corneal scarring were the most common causes of visual impairment in our cohort.
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Affiliation(s)
- Manjushree Bhate
- Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute Hyderabad, India
| | - Anthony Vipin Das
- Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swati Singh
- Ophthalmic Plastic Surgery Services, L V Prasad Eye Institute, Hyderabad, Telangana, India.
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4
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Baelen H, Esschendal AM, De Brucker Y, Foulon I, Topsakal V, Gordts F. Congenital facial nerve palsy: Single center study. Front Pediatr 2023; 11:1077238. [PMID: 36891227 PMCID: PMC9986544 DOI: 10.3389/fped.2023.1077238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Objectives This study will list the most common comorbidities of congenital facial nerve palsy and how to detect and treat them, with special attention for ENT-problems such as hearing loss. Congenital facial nerve palsy is a very rare entity but in UZ Brussels hospital there was a follow-up of 16 children in the last 30 years. Methods Literature review has been done, combined with thorough research of our own series of 16 children with congenital facial nerve palsy. Results Congenital facial nerve palsy can be part of a known syndrome, most commonly Moebius syndrome, but can also appear solely. It appears often bilateral and with a severe gradation. In our series, hearing loss is frequently seen in association with congenital facial nerve palsy. Other abnormalities are dysfunction of the abducens nerve, ophthalmological problems, retro- or micrognathism and abnormalities of limbs or heart. The majority of the children in our series underwent radiological imaging (CT and/or MRI): the facial nerve but also the vestibulocochlear nerve and middle and inner ear can be evaluated. Conclusion A multidisciplinary approach of congenital facial nerve palsy is recommended as it can affect various bodily functions. Radiological imaging needs to be done to acquire additional information that can be useful for diagnostic and therapeutic purposes. Although congenital facial nerve palsy may not be treatable itself, its comorbidities can be treated and improve the quality of life of the affected child.
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Affiliation(s)
- Hermine Baelen
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital UZ Brussel, Brussels, Belgium.,Faculteit Geneeskunde en Farmacie, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anne-Marie Esschendal
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital UZ Brussel, Brussels, Belgium
| | - Yannick De Brucker
- Department of Radiology, University Hospital UZ Brussel, Brussels, Belgium
| | - Ina Foulon
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital UZ Brussel, Brussels, Belgium.,Faculteit Geneeskunde en Farmacie, Vrije Universiteit Brussel, Brussels, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital UZ Brussel, Brussels, Belgium.,Faculteit Geneeskunde en Farmacie, Vrije Universiteit Brussel, Brussels, Belgium
| | - Frans Gordts
- Department of Otorhinolaryngology, Head and Neck Surgery University Hospital UZ Brussel, Brussels, Belgium.,Faculteit Geneeskunde en Farmacie, Vrije Universiteit Brussel, Brussels, Belgium
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Jančić J, Zeković J, Ćetković M, Nikolić B, Ivančević N, Vučević D, Nešić Z, Milovanović S, Radenković M, Samardžić J. Acute Peripheral Facial Nerve Palsy in Children and Adolescents: Clinical Aspects and Treatment Modalities. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2022; 22:CNSNDDT-EPUB-126028. [PMID: 36045521 DOI: 10.2174/1871527321666220831095204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/07/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
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: 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) - 74 (57.4%) patients followed by middle ear infections - 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, severity of clinical presentation, and 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 in three weeks after initial presentation, regardless of etiology, age, and therapy.
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Affiliation(s)
- Jasna Jančić
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Serbia
| | - Janko Zeković
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
| | - Mila Ćetković
- Institute of Histology and Embryology, Faculty of Medicine, University of Belgrade, Serbia
| | - Blažo Nikolić
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Serbia
| | - Nikola Ivančević
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Serbia
| | - Danijela Vučević
- Institute of Pathophysiology \\\'Ljubodrag Buba Mihailovic\\\', Faculty of Medicine, University of Belgrade, Serbia
| | - Zorica Nešić
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
| | - Srđan Milovanović
- Clinic of Psychiatry, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbia
| | - Miroslav Radenković
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
| | - Janko Samardžić
- Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Serbia
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Serbia
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Tomé S, Matos J, Barreto J, Carvalho J, Leal J, Aguiar Branco C. Congenital Facial Paralysis Revealing an Aplasic Facial Nerve: A Report of Two Cases. Am J Phys Med Rehabil 2022; 101:e76-e79. [PMID: 35067557 DOI: 10.1097/phm.0000000000001970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Congenital facial palsy is a rare condition, usually related to a traumatic event during birth or as a feature of a syndrome. In this report, two cases of infants with peripheral facial palsy since birth are described, in which magnetic resonance imaging demonstrated unilateral aplasia of the facial nerve. There are only a few cases with similar findings described in the literature. A multidisciplinary approach is recommended to provide the best care. Although no reinnervation of the facial muscles is likely to occur, rehabilitative therapies may be valuable as complementary treatments.
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Affiliation(s)
- Sónia Tomé
- From the Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal (ST, JM, JB, JC, JL, CAB); and Faculty of Dental Medicine, University of Porto, Porto, Portugal (CAB)
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Walsh PS, Gray JM, Ramgopal S, Lipshaw MJ. Risk of malignancy following emergency department Bell's palsy diagnosis in children. Am J Emerg Med 2022; 53:63-67. [PMID: 34992025 DOI: 10.1016/j.ajem.2021.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To quantify the risk of malignancy following the emergency department (ED) diagnosis of Bell's Palsy (BP) using a large retrospective cohort. STUDY DESIGN We performed a cohort study using the Pediatric Health Information System database. We included all children (6 months - 17 years) from 2011 to 2020 with an ED diagnosis of BP. We excluded children with previous neurologic chronic condition or malignancy diagnosed during or prior to the index visit. Our primary outcome was diagnosis of malignancy within 60 days following the index ED visit. We compared clinical characteristics between children with and without new-onset malignancy. RESULTS Of 12,272 encounters for BP, 41 had a new oncologic diagnosis within 60 days (0.33%, 95% confidence interval [CI]: 0.25-0.45%). Median time to oncologic diagnosis was 22 days. Primary CNS malignancy (59%) and leukemia (17.1%) were the most common diagnoses. Younger children had a higher incidence of new oncologic diagnosis compared with older children. Incidences were 0.68% (95% CI 0.36-1.3%), 0.70% (95% CI 0.38-1.3%), 0.26% (95% CI 0.15-0.47%), and 0.21% (95% CI 0.12-0.37%) for children aged <2 years, 2-5 years, 6-11 years, and 12-17 years respectively. CONCLUSIONS We found a small but potentially clinically significant rate of new-onset oncologic diagnosis within 60 days after BP diagnosis in the ED, especially in children younger than 5 years. Further studies of the diagnostic utility of laboratory testing or neuroimaging and the risk of empiric steroids in children with BP are needed.
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Affiliation(s)
- Patrick S Walsh
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America.
| | - James M Gray
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | - Sriram Ramgopal
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States of America
| | - Matthew J Lipshaw
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
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8
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Acute Facial Nerve Palsy in Children: Gold Standard Management. CHILDREN 2022; 9:children9020273. [PMID: 35204994 PMCID: PMC8870855 DOI: 10.3390/children9020273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
Abstract
Facial nerve palsy (FNP) is a common illness in the paediatric emergency department. Missed or delayed diagnosis can have a serious impact on a patient’s quality of life. The aim of this article is to give a recent overview of this pathology in terms of the causes, diagnosis, red flag symptoms, complementary examinations, treatments and follow-up in the child population. In cases of acquired, acute onset and isolated FNP, Bell’s palsy can be assumed, and no further investigation is required. In any other scenario, complementary examinations are required. Treatment depends on the aetiology. Corticosteroids, in addition to antiviral medication, are recommended to treat Bell’s palsy whenever a viral infection is suspected. However, the lack of randomised control trials in the paediatric population does not allow us to comment on the effectiveness of these treatments. In all cases, treated or not, children have a very good recovery rate. This review emphasises the necessity of randomised control trials concerning this frequent neurological pathology in order to better treat these children.
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9
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Bilge S, Mert GG, Hergüner MÖ, İncecik F, Sürmelioğlu Ö, Bilen S, Yılmaz L. Peripheral facial nerve palsy in children: clinical manifestations, treatment and prognosis. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022; 58:152. [PMCID: PMC9734354 DOI: 10.1186/s41983-022-00596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
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.
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Affiliation(s)
- Serap Bilge
- grid.98622.370000 0001 2271 3229Department of Pediatric Neurology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Gülen Gül Mert
- grid.98622.370000 0001 2271 3229Department of Pediatric Neurology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - M. Özlem Hergüner
- grid.98622.370000 0001 2271 3229Department of Pediatric Neurology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Faruk İncecik
- grid.98622.370000 0001 2271 3229Department of Pediatric Neurology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Özgür Sürmelioğlu
- grid.98622.370000 0001 2271 3229Department of Ear, Nose &Throat, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Sevcan Bilen
- grid.98622.370000 0001 2271 3229Department of Pediatric Emergency, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Levent Yılmaz
- grid.98622.370000 0001 2271 3229Department of Pediatric Emergency, Faculty of Medicine, Çukurova University, Adana, Turkey
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Çirakli S. Effect of etiological factors on treatment success of pediatric facial paralysis: Success of facial paralysis in children. Medicine (Baltimore) 2021; 100:e28195. [PMID: 34918676 PMCID: PMC8677891 DOI: 10.1097/md.0000000000028195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/16/2021] [Indexed: 01/05/2023] Open
Abstract
Facial paralysis is a clinical condition that causes anxiety in the family and is one of the reasons for urgent admission to the hospital. The purpose of this article is to evaluate to reveal the relationship between etiology and treatment results in childhood facial paralysis.Thirty-three patients who presented with facial paralysis between May 2018 and May 2020, had adequate follow-up were included in the study. Data were reviewed age, gender, side, etiology, features of family, treatment, results, and recurrences.The ages of the cases ranged from 21 months to 17 years, with the mean age was 13.1 years. Ten of the cases were male (30.3%), 23 of them were female (69.7%). It was observed that 15 (45.4%) of the paralysis were on the right half of the face, 17 (51.5%) were on the left side of the face, and 1 (3.1%) had bilateral involvement. However, it was learned from the story that 3 cases had recurrence. Thirty-two (96.9%) of the cases were peripheral and 1 (3.1%) had central facial paralysis. No cause could be found in the etiology of other peripheral paralysis cases and it was considered as Bell Paralysis. According to the House Brackmann Stage at the time of admission of 30 patients who were given steroid treatment, 10 patients were evaluated as stage 6, 15 patients as stage 5, and 5 patients as stage 4. After 6 months of follow-up, 27 patients were evaluated as stage 1 and 2 patients as stage 2. Recurrence was not observed in any of the patients who recovered.It was concluded that etiology determines the success of treatment in facial paralysis.
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Wang CS, Sakai M, Khurram A, Lee K. Facial nerve palsy in children: A case series and literature review. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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McHugh CI, Mokhtari TE, Cohen MS, Hartnick CJ. Unilateral Facial Paralysis. J Pediatr 2021; 235:293-295. [PMID: 33894264 DOI: 10.1016/j.jpeds.2021.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Christopher I McHugh
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology and, Harvard Medical School, Boston, MA
| | - Tara E Mokhtari
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology and, Harvard Medical School, Boston, MA
| | - Michael S Cohen
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology and, Harvard Medical School, Boston, MA
| | - Christopher J Hartnick
- Massachusetts Eye and Ear Infirmary, Department of Otolaryngology and, Harvard Medical School, Boston, MA
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Kharel S, Koirala DP, Shrestha S, Sedai H, Shrestha BM, Homagain S, Kandel S. Heterotaxy syndrome with complex congenital heart disease, facial palsy, and asplenia: A rare newborn finding. Clin Case Rep 2021; 9:e04573. [PMID: 34401157 PMCID: PMC8347632 DOI: 10.1002/ccr3.4573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/05/2021] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
Heterotaxy syndrome is associated with asplenia/polysplenia and complex congenital heart disease. Facial palsy in heterotaxy is very rare. The management is still challenging with a poor prognosis. Proper counseling to the family about the disease course, treatment modalities, and outcomes is essential.
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Affiliation(s)
- Sanjeev Kharel
- Institute of MedicineMaharajgunj Medical CampusKathmanduNepal
| | - Dinesh Prasad Koirala
- Department of Gastrointestinal and General SurgeryPediatric Surgery UnitTribhuvan UniversityTeaching HospitalKathmanduNepal
| | - Suraj Shrestha
- Institute of MedicineMaharajgunj Medical CampusKathmanduNepal
| | - Hari Sedai
- Institute of MedicineMaharajgunj Medical CampusKathmanduNepal
| | | | - Sushan Homagain
- Institute of MedicineMaharajgunj Medical CampusKathmanduNepal
| | - Suraj Kandel
- Institute of MedicineMaharajgunj Medical CampusKathmanduNepal
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Malik M, Cubitt JJ. Paediatric facial paralysis: An overview and insights into management. J Paediatr Child Health 2021; 57:786-790. [PMID: 33983648 DOI: 10.1111/jpc.15498] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/08/2021] [Accepted: 03/13/2021] [Indexed: 12/19/2022]
Abstract
The aim of this article is to provide an overview on paediatric facial paralysis, looking into aetiology, epidemiology, assessment and investigation and subsequent treatment options available. Facial paralysis describes the inability to activate the muscles of fascial expression. Overall, it affects 2.7 per 100 000 children under 10 years old and 10.1 per 100 000 children over 10 years old each year. There are many causes of facial paralysis and the outcomes and necessary treatments vary depending on the cause. The mainstays of medical management are corticosteroids and facial therapy; however, when the facial palsy persists, facial deformity surgery is an option to improve the facial symmetry, protect vision and recreate dynamic movement.
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Affiliation(s)
- Mohammad Malik
- The Welsh Centre of Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
| | - Jonathan J Cubitt
- The Welsh Centre of Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom
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15
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Pediatric facial reanimation: An algorithmic approach and systematic review. Arch Plast Surg 2020; 47:382-391. [PMID: 32971589 PMCID: PMC7520236 DOI: 10.5999/aps.2020.00710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/15/2020] [Indexed: 12/04/2022] Open
Abstract
Facial palsy has a broad clinical presentation and the effects on psychosocial interaction and facial functions can be devastating. Pediatric facial palsy, in particular, introduces unique familial and technical considerations as anatomy, future growth potential, and patient participation influence treatment planning. Though some etiologies of pediatric facial palsy are self-limiting, congenital and long-standing facial palsies pose difficult challenges that require a combination of surgical, adjunctive, and rehabilitative techniques to achieve facial reanimation. Given the spectrum of ages and symptom severity, as well as the various surgical options available for facial palsy, a tailored approach needs to be developed for each child to restore facial balance and function. Here, we review the etiologies, workup, and treatment of pediatric facial palsy and present our novel algorithmic approach to treatment.
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Coviello C, Remaschi G, Becciani S, Montano S, Corsini I, Mussa F, Basile M, Dani C. Neonatal Cerebellar Hemorrhage and Facial Nerve Palsy: An Unusual Association. AJP Rep 2020; 10:e262-265. [PMID: 33094015 PMCID: PMC7571563 DOI: 10.1055/s-0040-1715162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/30/2019] [Indexed: 11/16/2022] Open
Abstract
Cerebellar hemorrhage is rare in term newborns and is most often seen after traumatic birth. Lifelong sequelae include motor and cognitive impairment. We report the uncommon case of a late preterm infant born by spontaneous delivery who showed right peripheral facial palsy at 24 hours of life. Cranial ultrasound showed lateral ventricles dilatation and a diffuse hyperechoic round lesion in the right cerebellar hemisphere. The computed tomography scan confirmed a hemorrhagic lesion in the right cerebellar hemisphere and in the vermis with midline shift and intraventricular bleeding. Ommaya reservoir was inserted and used for a few days. The facial palsy gradually recovered to a complete remission after 6 weeks. Follow-up examinations at 12 and 18 months evidenced infant's delayed motor function, hyperreflexia, tremors, and speech delay.
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Affiliation(s)
- Caterina Coviello
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Giulia Remaschi
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Sabrina Becciani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Simona Montano
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy
| | - Federico Mussa
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - Massimo Basile
- Interdisciplinary Specialist Department, Radiology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Italy
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Yokoyama T, Takemura Y, Kuroda R, Taniguchi C, Jinkawa A, Yamamiya M, Obata M, Miyashita K, Inoue M, Sakazume S, Ohta K. Facial nerve palsy with splenomegaly. J Paediatr Child Health 2020; 56:974-975. [PMID: 31850606 DOI: 10.1111/jpc.14728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 11/23/2019] [Accepted: 11/28/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Tadafumi Yokoyama
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Yuta Takemura
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Rie Kuroda
- Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Chihiro Taniguchi
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Asumi Jinkawa
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Mari Yamamiya
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Misato Obata
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Kengo Miyashita
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Mika Inoue
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Shinobu Sakazume
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Kazuhide Ohta
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
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Savasta S, Rossi A, Foiadelli T, Licari A, Elena Perini AM, Farello G, Verrotti A, Marseglia GL. Melkersson⁻Rosenthal Syndrome in Childhood: Report of Three Paediatric Cases and a Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071289. [PMID: 30974872 PMCID: PMC6479526 DOI: 10.3390/ijerph16071289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022]
Abstract
Melkersson–Rosenthal syndrome (MRS) in children is a rare condition, clinically characterised by a triad of synchronous or metachronous symptoms: recurrent peripheral facial palsy, relapsing orofacial oedema, and a fissured tongue; the most recent review published on the topic has reported 30 published patients. The aetiology of this disease is still unclear. However, genetic factors, as well as alterations in immune functions, infections, and allergic reactions have been postulated. We report three children suffering from MRS and perform a literature review of paediatric cases. Taking into account that clinical and laboratoristical criteria for the diagnosis of MRS are lacking, this syndrome is probably underestimated, and we suggest increasing awareness of such a rare syndrome. Close multidisciplinary follow-up of these children with a team composed by paediatricians, neurologists, neuro-ophthalmologists, dermatologists, and otolaryngologists is crucial to guarantee exhaustive management and treatment success, while minimising relapses.
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Affiliation(s)
- Salvatore Savasta
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Alessandra Rossi
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Thomas Foiadelli
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Amelia Licari
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | | | - Giovanni Farello
- Pediatric Clinic⁻Department of Life, Health and Environmental Sciences⁻Piazzale Salvatore Tommasi 1, 67100 Coppito (AQ), Italy.
| | - Alberto Verrotti
- Pediatric Clinic⁻Biotechnological and Applied Clinical Sciences Via Vetoio (Coppito 2), 67100 Coppito (AQ), Italy.
| | - Gian Luigi Marseglia
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
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Psillas G, Antoniades E, Ieridou F, Constantinidis J. Facial nerve palsy in children: A retrospective study of 124 cases. J Paediatr Child Health 2019; 55:299-304. [PMID: 30144181 DOI: 10.1111/jpc.14190] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/13/2018] [Accepted: 07/22/2018] [Indexed: 11/30/2022]
Abstract
AIM To report the causes and clinical evaluation of children with facial nerve palsy (FNP) admitted to an affiliated university hospital during a 5-year period (2011-2015). METHODS A total of 124 children were retrospectively categorised into two groups: idiopathic Bell's palsy (109 patients) and the second group into other FNP aetiologies (15 patients). All children received a standardised work-up and follow-up. Therapy consisted of steroid administration associated with antiviral treatment when a viral infection was suspected. RESULTS All children of the first group had a full recovery under oral steroids within 2 months of treatment. From the second group, seven children (46%) had a viral infection based on serological findings, two of them were positive for neurotropic herpes viruses, and one had Ramsay Hunt syndrome; six children with infectious FNP had recurrent FNP on the ipsilateral or contralateral side. Five patients had FNP as a complication of acute otitis media; three of them (60%) had partial or full recovery postoperatively. One child developed FNP following temporal bone trauma that had an uneventful recovery with conservative treatment. One child suffered from Melkersson-Rosenthal syndrome, and another child presented with FNP associated with unilateral hemiparesis following an ischaemic cerebral infarct. CONCLUSIONS Facial palsy in children is a manifestation of a heterogeneous group of causes. The most common aetiology of FNP in children in our study was idiopathic (Bell's palsy), followed by infective causes, such as acute otitis media and neurotropic herpes viruses. Therefore, treatment should be adapted to each patient depending on the underlying disease and severity of FNP.
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Affiliation(s)
- George Psillas
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Elias Antoniades
- 1st Academic Neurosurgery Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Fotini Ieridou
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Magnetic resonance imaging of developmental facial paresis: a spectrum of complex anomalies. Neuroradiology 2018; 60:1053-1061. [PMID: 30074067 DOI: 10.1007/s00234-018-2063-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Despite its clinical implications, the MRI features of developmental facial paresis (DFP) were described in a few case reports. This study aims to describe MRI features of DFP in relation to the embryological development with a proposed radiological new grading system. METHODS The clinical records and MRI of the brain and internal auditory canal of 11 children with DFP were retrospectively reviewed. The following sequences were analyzed: axial, oblique sagittal SPACE of the internal auditory canal and brainstem; axial T2, T1WI and coronal T2WI of the brain. The severity of the maldevelopment of the seventh nerve was graded from 0 to 4: 0 = no abnormalities, 1 = unilateral facial nerve hypoplasia, 2 = unilateral facial nerve aplasia, 3 = aplasia or hypoplasia involving facial nerves on both sides, and 4 = facial nerve aplasia or hypoplasia associated with other cranial nerve palsy. RESULTS Isolated facial nerve palsy was diagnosed in seven patients. It was of grade 1 in five and grade 3 in two. Hypoplasia of the nerve with interrupted course was encountered in two cases. Other associated cranial nerve abnormalities (grade 4) were seen in four patients; two of them were diagnosed previously as Moebius syndrome. In addition to inner ear anomalies, middle and external ear and parotid gland anomalies were described. CONCLUSION To our knowledge, this is the largest series of patients with DFP that represents a continuum of isolated and combined malformations. Understanding of embryological basis can give insights into the anomalous development of the facial nerve.
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Pandita A, Mishra N, Gupta G, Shukla A. Neonatal facial palsy, a case series: is CPAP the culprit? BMJ Case Rep 2018; 2018:bcr-2018-224842. [PMID: 30002154 DOI: 10.1136/bcr-2018-224842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report a case series of three idiopathic unilateral facial nerve palsies in neonates with no identified risk factors. Neuroimaging done was normal. All the neonates had complete spontaneous recovery within a month, with no residual deficits. As per our knowledge, there are very few case reports of facial palsy in a neonate reported in literature and are often labelled as idiopathic.
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Affiliation(s)
- Aakash Pandita
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Namita Mishra
- Department of Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Girish Gupta
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Shukla
- Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Karalok ZS, Taskin BD, Ozturk Z, Gurkas E, Koc TB, Guven A. Childhood peripheral facial palsy. Childs Nerv Syst 2018; 34:911-917. [PMID: 29427137 DOI: 10.1007/s00381-018-3742-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 01/31/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The objectives of this study were to evaluate the demographic and clinical characteristics, causes, treatment patterns, outcome, and recurrence of childhood peripheral facial palsy. METHODS We performed a retrospective study of 144 peripheral facial palsy patients, under 18 years old in a tertiary care pediatric hospital. Medical charts were reviewed to analyze the age, gender, side of facial nerve paralysis, family history, cause, grading by the House-Brackmann Facial Nerve Grading Scale (HBS), results of diagnostic tests, therapies, outcomes, and recurrence. RESULTS Causes were as follows: 115 idiopathic (Bell's palsy) facial palsy (79.9%), 17 infections (11.8%) (9 otitis media, 4 varicella zoster virus (VZV) infection, 3 tooth abscess, and 1 group A β-hemolytic streptococcus infection), 7 trauma (4.9%), 4 congenital-syndrome (2.8%), and 1 (0.7%) arterial hypertension. There was no difference in age, sex, family history, grading, or outcome between idiopathic and cause-defined facial palsy. At the end of the first year, our recovery rates were 98.3%. No significant difference in recovery outcome was detected between the patients who were treated with and without steroid treatment. Thirteen (9%) patients had recurrent attacks, and no differences in the outcomes of patients with recurrent facial palsy were observed. Recurrence time ranged from 6 months to 6 years. CONCLUSION The results of this study indicate that both Bell's palsy and cause-defined facial palsy in children have a very good prognosis. Medical treatment based on corticosteroids is not certainly effective in improving outcomes in children. Recurrent attacks occurred in 6 years from the onset which leads to the conclusion that we should have a long-term follow-up of patients diagnosed with Bell's palsy.
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Affiliation(s)
- Zeynep Selen Karalok
- Department of Pediatric Neurology, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey
| | - Birce Dilge Taskin
- Department of Pediatric Neurology, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey
| | - Zeynep Ozturk
- Department of Pediatric Neurology, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
| | - Esra Gurkas
- Department of Pediatric Neurology, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey
| | - Tuba Bulut Koc
- Department of Pediatrics, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey
| | - Alev Guven
- Department of Pediatric Neurology, Ankara Children's Hematology-Oncology Training and Research Hospital, Ankara, Turkey
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Ito T, Watanabe H, Honjo M, Asamori T. Two pediatric cases of post-traumatic facial paralysis with delayed onset. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2018. [DOI: 10.1080/23772484.2018.1423619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Taku Ito
- Department of Otolaryngology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
- Department of Otolaryngology, Tokyo Medical and Denatal University, Tokyo, Japan
| | - Hiroki Watanabe
- Department of Otolaryngology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Motomu Honjo
- Department of Otolaryngology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Tomoaki Asamori
- Department of Otolaryngology, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
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Arican P, Dundar NO, Gencpinar P, Cavusoglu D. Efficacy of Low-Dose Corticosteroid Therapy Versus High-Dose Corticosteroid Therapy in Bell's Palsy in Children. J Child Neurol 2017; 32:72-75. [PMID: 27686096 DOI: 10.1177/0883073816668774] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bell's palsy is the most common cause of acute peripheral facial nerve paralysis, but the optimal dose of corticosteroids in pediatric patients is still unclear. This retrospective study aimed to evaluate the efficacy of low-dose corticosteroid therapy compared with high-dose corticosteroid therapy in children with Bell's palsy. Patients were divided into 2 groups based on the dose of oral prednisolone regimen initiated. The severity of idiopathic facial nerve paralysis was graded according to the House-Brackmann Grading Scale. The patients were re-assessed in terms of recovery rate at the first, third, and sixth months of treatment. There was no significant difference in complete recovery between the 2 groups after 1, 3, and 6 months of treatment. In our study, we concluded that even at a dose of 1 mg/kg/d, oral prednisolone was highly effective in the treatment of Bell's palsy in children.
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Affiliation(s)
- Pinar Arican
- 1 Department of Pediatric Neurology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Nihal Olgac Dundar
- 2 Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey
| | - Pinar Gencpinar
- 1 Department of Pediatric Neurology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Dilek Cavusoglu
- 2 Department of Pediatric Neurology, Izmir Katip Celebi University, Izmir, Turkey
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Shimada Dias M, Nakamura K, Sasaki T, Sugimoto H, Ito M. A case of congenital unilateral facial nerve aplasia. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2016. [DOI: 10.1080/23772484.2016.1247648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Peripheral facial palsy, the only presentation of a primitive neuroectodermal tumor of the skull base. Int J Surg Case Rep 2015; 19:47-50. [PMID: 26710328 PMCID: PMC4756191 DOI: 10.1016/j.ijscr.2015.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 12/12/2015] [Accepted: 12/13/2015] [Indexed: 11/28/2022] Open
Abstract
A 2-month-old male infant presenting with only peripheral facial palsy was diagnosed with a primitive neuroectodermal tumor of the skull base. Primitive neuroectodermal tumors located in the skull base are rarely detected in infants. After subtotal resection of the tumor, asymmetrical facial expression showed mild improvement.
Introduction Peripheral facial palsy is rarely caused by primary neoplasms, which are mostly constituted of tumors of the central nervous system, head and neck, and leukemia. Presentation of case A 2-month-old male infant presented with asymmetric facial expression for 3 weeks. Physical examination revealed suspicious findings of right peripheral facial palsy. Computed tomography of the temporal bone revealed a suspicious bone tumor centered in the right petrous bone involving surrounding bones with extension into the middle ear cavity and inner ear. Subtotal resection of the tumor was performed due to crucial structures adjacent the mass. Histopathology and immunohistochemistry of the resected tumor was consistent with primitive neuroectodermal tumor. Conclusion We report a rare case of a primitive neuroectodermal tumor located at the skull base presenting with only peripheral facial palsy.
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Ciorba A, Corazzi V, Conz V, Bianchini C, Aimoni C. Facial nerve paralysis in children. World J Clin Cases 2015; 3:973-979. [PMID: 26677445 PMCID: PMC4677084 DOI: 10.12998/wjcc.v3.i12.973] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 09/04/2015] [Accepted: 10/13/2015] [Indexed: 02/05/2023] Open
Abstract
Facial nerve palsy is a condition with several implications, particularly when occurring in childhood. It represents a serious clinical problem as it causes significant concerns in doctors because of its etiology, its treatment options and its outcome, as well as in little patients and their parents, because of functional and aesthetic outcomes. There are several described causes of facial nerve paralysis in children, as it can be congenital (due to delivery traumas and genetic or malformative diseases) or acquired (due to infective, inflammatory, neoplastic, traumatic or iatrogenic causes). Nonetheless, in approximately 40%-75% of the cases, the cause of unilateral facial paralysis still remains idiopathic. A careful diagnostic workout and differential diagnosis are particularly recommended in case of pediatric facial nerve palsy, in order to establish the most appropriate treatment, as the therapeutic approach differs in relation to the etiology.
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da Fonseca Filho GG, de Medeiros Cirne GN, Cacho RO, de Souza JC, Nagem D, Cacho EWA, Moran CA, Abreu B, Pereira SA. Neonatal peripheral facial paralysis' evaluation with photogrammetry: A case report. Int J Pediatr Otorhinolaryngol 2015; 79:2473-5. [PMID: 26607566 DOI: 10.1016/j.ijporl.2015.10.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/26/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
Abstract
Facial paralysis in newborns can leave functional sequelae. Determining the evolution and amount of functional losses requires consistent evaluation methods that measure, quantitatively, the evolution of clinical functionality. This paper reports an innovative method of facial assessment for the case of a child 28 days of age with unilateral facial paralysis. The child had difficulty breast feeding, and quickly responded to the physical therapy treatment.
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Affiliation(s)
| | | | | | | | - Danilo Nagem
- Universidade Federal do Rio Grande do Norte, FACISA/UFRN, RN, Brazil
| | | | | | - Bruna Abreu
- Pediatric and Neonatal Physiotherapy by Universidade Católica de Goiás, Brazil
| | - Silvana Alves Pereira
- Universidade Federal do Rio Grande do Norte, and University Hospital Ana Bezerra's Residence Program, UFRN/HUAB/EBSERH, RN, Brazil.
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Özkale Y, Erol İ, Saygı S, Yılmaz İ. Overview of pediatric peripheral facial nerve paralysis: analysis of 40 patients. J Child Neurol 2015; 30:193-9. [PMID: 24810082 DOI: 10.1177/0883073814530497] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis.
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Affiliation(s)
- Yasemin Özkale
- Department of Pediatrics, Baskent University Faculty of Medicine, Adana, Turkey
| | - İlknur Erol
- Division of Child Neurology, Department of Pediatrics, Baskent University Faculty of Medicine, Adana, Turkey
| | - Semra Saygı
- Division of Child Neurology, Department of Pediatrics, Baskent University Faculty of Medicine, Adana, Turkey
| | - İsmail Yılmaz
- Department of Otolaryngology-Head and Neck Surgery, Baskent University Faculty of Medicine, Adana, Turkey
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Abstract
There is growing evidence that steroids are not beneficial for treatment of paediatric patients with Bell's palsy. To investigate, we conducted a retrospective longitudinal study examining notes of 100 children, over 12 years coded for facial nerve palsy. Of the 79 diagnosed with Bell's palsy, all recovered, and for 46 patients we had data on interval from onset of symptoms to resolution (median duration in treated group = 5 weeks, range = 39; median duration in untreated group = 6 weeks, range = 11; P = .86). From our results, we conclude that all children with Bell's palsy recovered, with or without steroid treatment, with no statistically significant difference in symptoms duration. Complications of unresolved Bell's palsy can have important long-term functional and psychosocial consequences. Therefore, we need further research on use of steroids in children with complete/severe cases; it would be a shame to omit treatment due to "absence of evidence" rather than "evidence of absence."
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Affiliation(s)
- Abdul Qader Ismail
- Paediatric Department, Good Hope Hospital, Sutton Coldfield, Birmingham, England
| | - Oluwaseyi Alake
- Paediatric Department, Good Hope Hospital, Sutton Coldfield, Birmingham, England
| | - Chetana Kallappa
- Paediatric Department, Good Hope Hospital, Sutton Coldfield, Birmingham, England
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Samsudin WSW, Sundaraj K. Clinical and non-clinical initial assessment of facial nerve paralysis: A qualitative review. Biocybern Biomed Eng 2014. [DOI: 10.1016/j.bbe.2014.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Toledo del Castillo B, Kyriakos G, Roldán Martín M. Tratamiento con hormona de crecimiento y parálisis de Bell: ¿coincidencia o consecuencia? An Pediatr (Barc) 2014; 80:61-2. [DOI: 10.1016/j.anpedi.2013.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/02/2013] [Accepted: 03/04/2013] [Indexed: 10/26/2022] Open
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Affiliation(s)
- Anand Kumar Gupta
- Department of Neonatology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Abstract
A 5-year-old girl with precursor B-cell acute lymphoblastic leukemia developed peripheral-type right facial palsy and very faint erythema on her right pinna during maintenance therapy. Acyclovir was started for possible zoster infection. The following day, vesicles appeared and a diagnosis of Ramsay Hunt syndrome was made. Prednisolone was started on day 5 after onset. Her facial palsy recovered within 6 months. Ramsay Hunt syndrome is a rare cause of facial palsy in patients with acute lymphoblastic leukemia, and this is the first case report. Preemptive therapy with acyclovir before the development of vesicles should help the patient recover from facial palsy.
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Hamizan AW, Yean KT, Abdullah A. Congenital bilateral facial nerve hypoplasia with sensorineural hearing loss: a case report. Int J Pediatr Otorhinolaryngol 2012; 76:455-9. [PMID: 22281372 DOI: 10.1016/j.ijporl.2012.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 12/31/2011] [Accepted: 01/02/2012] [Indexed: 11/16/2022]
Abstract
A 3-year-old child presented with congenital bilateral facial nerve palsy with bilateral profound sensorineural hearing loss. High Resolution Computed Tomogram (HRCT) of the temporal bones found bilateral atresia of cochlear nerve canals, incomplete partition of the cochleae and narrow facial nerve canals. Magnetic resonance imaging (MRI) revealed bilateral hypoplasia of facial nerves and aplasia of both vestibulocochlear nerves. There have been no other reported cases with this presentation. The possible aetiology and treatment options for the patient are discussed. We highlighted the review of aplasia/hypoplasia of the facial nerve and hypoplasia of cochlear nerve canal.
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Affiliation(s)
- Aneeza W Hamizan
- Department of Otorhinolaryngology-Head & Neck Surgery, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
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