Facial Nerve Palsy Etiology and Approach to Diagnosis and Treatment

Division of Emergency Medicine, Children's National Medical Center, Washington, DC, USA.
Pediatric emergency care (Impact Factor: 0.92). 10/2010; 26(10):763-9; quiz 770-3. DOI: 10.1097/PEC.0b013e3181f3bd4a
Source: PubMed

ABSTRACT Facial nerve palsy has a broad differential diagnosis and possible psychological and anatomical consequences. A thorough investigation must be performed to determine the cause of the palsy and to direct treatment. If no cause can be found, therapy with prednisone with or without an antiviral medication can be considered and begun as early as possible after onset of symptoms. Resolution and time to recovery vary with etiology, but overall prognosis is good.

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    ABSTRACT: La parálisis de Bell es la causa más común de parálisis del nervio facial unilateral en la infancia. Aunque el diagnóstico depende de la exclusión de otras causas menos comunes, como infecciosas, traumáticas, asociada a tumores o a hipertensión, los pediatras tienden a diagnosticar la parálisis idiopática de Bell siempre que un niño presenta parálisis facial. En este informe se presenta una niña de ocho años con parálisis facial recurrente y alternante como primer síntoma de hipertensión arterial sistémica. Recibió tratamiento con esteroides sin previa medición de la tensión arterial, lo cual pudo agravar su cuadro. Debe tenerse en cuenta esta asociación y medir siempre la tensión arterial antes de considerar la terapia con esteroides para la parálisis de Bell. Deben tenerse en cuenta las causas menos comunes de parálisis facial adquirida, especialmente cuando se presentan episodios recurrentes y alternantes.
    Archivos argentinos de pediatría 12/2013; 111(6). DOI:10.5546/aap.2013.e133 · 0.29 Impact Factor
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    ABSTRACT: Bell's palsy is the most common cause of acquired unilateral facial nerve palsy in childhood. Although the diagnosis depends on the exclusion of less common causes such as infectious, traumatic, malignancy associated and hypertension associated etiologies, pediatricians tend to diagnose idiopatic Bell's palsy whenever a child admits with acquired facial weakness. In this report, we present an eight year old girl, presenting with recurrent and alternant facial palsy as the frst symptom of systemic hypertension. She received steroid treatment without measuring blood pressure and this could worsen hypertension. Clinicians should be aware of this association and not neglect to measure the blood pressure before considering steroid therapy for Bell's palsy. In addition, the less common causes of acquired facial palsy should be kept in mind, especially when recurrent and alternant courses occur.
    Archivos argentinos de pediatría 12/2013; 111(6). DOI:10.1590/S0325-00752013000600015 · 0.29 Impact Factor
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    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.
    Journal of child neurology 05/2014; DOI:10.1177/0883073814530497 · 1.67 Impact Factor