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Facial palsy, an unusual presenting feature of childhood leukemia
Shedthikere Krishnamurthy1, Arie L Weinstock, Sharon H Smith
1Department of Neurology, State University of New York at Buffalo, Children's Hospital of Buffalo, Buffalo, New York 14222, USA.
Insights
Facial paralysis can be an early sign of leukemia in children, often misdiagnosed as Bell's palsy. Prompt evaluation for leukemia and central nervous system disease is crucial for affected children.
Area of Science:
- Pediatric Oncology
- Neurology
Background:
- Leukemia is a common childhood cancer, but facial paralysis is an uncommon presenting symptom.
- Bell's palsy is a frequent diagnosis for facial nerve weakness in children.
Observation:
- Three pediatric patients presented with lower motor neuron facial paresis as the initial sign of leukemia.
- All three patients were initially diagnosed with Bell's palsy.
Findings:
- Facial paralysis in young children warrants a thorough evaluation for underlying conditions, including leukemia.
- Leukemic infiltration of the central nervous system can cause cranial neuropathies.
Implications:
- Early recognition of facial paralysis in children can lead to earlier leukemia diagnosis.
- Children with leukemia and cranial neuropathy require prompt and intensive central nervous system-directed therapy.
Abstract:
Facial paralysis is not a well-recognized presenting feature of leukemia in children. We present two infants and one older child in whom the initial manifestation of their leukemia was lower motor neuron facial paresis. Initial diagnosis in all the patients was Bell's palsy. The presence of Bell's palsy in young children requires a complete evaluation, including consideration of leptomeningeal disease. Leukemic children presenting with cranial neuropathy require intensive central nervous system therapy.