Article Text

other Versions

PDF
Medium term outcome in Bell's palsy in children
  1. Roisin McNamara1,2,
  2. Jennifer Doyle1,
  3. Mary Mc Kay1,
  4. Peter Keenan1,
  5. Franz E Babl2,3
  1. 1Emergency Department, Children's University Hospital, Dublin, Ireland
  2. 2Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
  3. 3Royal Children's Hospital, Murdoch Children's Research Institute, and University of Melbourne, Melbourne, Australia
  1. Correspondence to Dr Roisin McNamara, Emergency Department, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia; roisinmcnamara{at}hotmail.com

Abstract

Objective Bell's palsy is a non-life threatening disorder with important functional and psychosocial effects. While recent research has shown significant benefit from treatment with steroids in adults, there have been no conclusive studies demonstrating benefit in children. This study set out to explore the medium term resolution of symptoms in Bell's palsy presenting to the emergency department (ED).

Patients and Methods This was a retrospective cohort study of children attending an Irish paediatric ED with a diagnosis of Bell's palsy. Patients were identified via the ED database. The primary outcome measure was resolution at follow-up call (6–18 months after presentation). Secondary outcome measures were ED treatment, imaging and time to resolution of symptoms.

Results There were 48 presentations, involving 45 patients. Left and right-sided palsies were equally represented. Of these, 16 (33%) received prednisolone. MRI was performed in five cases (10%), four were normal and one did not change management. In follow-up telephone contact, of 35 presentations, 28 (80%, 95% CI 63% to 91%) had complete resolution, six (17%, 95% CI 7% to 34%) partial resolution to variable degrees and one patient showed no improvement. Of the 13 patients who had received prednisolone, nine (69%, 95% CI 39% to 91%) had complete resolution; of the 22 patients who were not treated with prednisolone 19 (86%, 95% CI 65% to 97%) had complete resolution (p=0.22).

Conclusions The majority of children with Bell's palsy have complete resolution of the facial weakness. Steroid use is highly variable and warrants a placebo controlled randomised trial.

  • Analgesia pain controlchild
  • child
  • clinical
  • emergency department
  • facial nerve palsy
  • neurology
  • paediatric emergency med
  • steroid
View Full Text

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Children's University Hospital Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.