Abstract
The prognosis of children with Bell’s palsy remains unclear due to its relatively low incidence, and thus, the small number of patients included in individual studies. To evaluate the prognosis of children with Bell’s palsy and identify the predictive value of specific factors that contribute to complete recovery, a retrospective cohort study was conducted of all patients with Bell’s palsy who visited the outpatient clinic of our university hospital between January 2005 and December 2020. We identified the parameters associated with a favorable recovery after 6 months in pediatric patients with Bell’s palsy. Factors recorded for each patient included age, sex, side affected by palsy, time between symptom onset and start of treatment, treatment methods, and the House–Brackmann grade (H–B) grade. The results of the multivariable analysis revealed that the lower degree of initial facial nerve paralysis presented as H–B grade II–IV was a significant favorable prognostic factor (OR: 3.86; 95% CI: 1.27–11.70; p < 0.05). Our results showed that the most important factor influencing the complete recovery of Bell’s palsy in children was the lower initial H–B grade at initial presentation.
Highlights
Idiopathic facial paralysis, known as Bell’s palsy, is a disease characterized by acute, unilateral, idiopathic peripheral facial palsy [3]
Complete recovery was associated with a lower initial House–Brackmann grade (H–B) grade (OR: 3.86; 95% confidence intervals (CI): 1.27–11.70; p < 0.05)
Our results showed that the most important factor influencing complete recovery was a lower H–B grade at initial presentation
Summary
Unilateral facial weakness of unknown cause develops rapidly, with Bell’s palsy considered the most common cause of facial paralysis in children compared with other etiologies, including traumatic, congenital, infectious and neoplastic causes [4,5,6]. The etiology and pathophysiology of Bell’s palsy in children are not completely understood. It can be caused by inflammation and edema of the facial nerve fibers, with infiltration of lymphocytes and associated demyelination or axonal degeneration [7,8]. Infections with many viruses have been reported to cause acute peripheral facial paralysis in children. These findings have suggested that treatment with corticosteroids and/or antiviral agents may be effective in patients with Bell’s palsy. The treatment of children, including the types and dosages of corticosteroids and antiviral agents, is empirical, based on each physician’s experience
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