Korean J Pediatr.  2018 Oct;61(10):332-337. 10.3345/kjp.2018.06380.

Comparison of conservative therapy and steroid therapy for Bell's palsy in children

Affiliations
  • 1Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Busan, Korea. pink2129@naver.com
  • 2Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Biochemical Research Institute, Yangsan, Korea.

Abstract

PURPOSE
Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment.
METHODS
We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed.
RESULTS
One hundred patients were included. Mean age at presentation was 7.4±5.62 years. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48).
CONCLUSION
Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.

Keyword

Peripheral facial paralysis; Bell palsy; Child

MeSH Terms

Adrenal Cortex Hormones
Age of Onset
Antiviral Agents
Bell Palsy*
Child*
Facial Nerve
Facial Paralysis
Humans
Neuroimaging
Paralysis
Prognosis
Retrospective Studies
Vaccination
Adrenal Cortex Hormones
Antiviral Agents
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