[Acquired peripheral facial palsy in children. Current data illustrated by 66 recent personal cases]

The authors observed 66 cases of peripheral facial palsy (PFP) in children during a 5-year period (1986-1990). Bell's palsy (idiopathic facial paralysis) occurred in 26 children (39.3%), 1 month to 14.5 years old, with a complete recovery in 95% of the cases; a surgical decompression was carried out in 2 cases. The PFP was related to otitis in 16 cases (24.2%): acute otitis media (6), mastitis (4), serous otitis (5), cholesteatoma (1); the treatment was medical and surgical in all cases with complete recovery in 15 cases. In 15 cases the PFP was secondary to trauma (13) or surgery (2); complete spontaneous recovery occurred in 11 cases, and partial recovery following surgical treatment in 2 cases. A viral origin was retained in 6 cases: herpes zoster (3), mumps (1), echovirus (1), herpes (1); the recovery was complete in 4 cases, partial in 2 cases. In 3 cases the PFP was related to a rare cause: lymphoma, metabolic acidosis, Melkerson-Rosenthal syndrome. Bell's palsy remains the main cause of PFP in childhood; other etiologies can be ruled out by the case history, a careful physical examination, and a limited number of laboratory and/or X-ray studies; medical treatment, in particular prednisone, does not seem to have an effect upon the rate of recovery which is spontaneously high; similarly there is no evidence that surgical decompression really modifies the rate of recovery so that the authors suggest that it should be reserved to the complete forms with no clinical and electrical evidence of recovery after 3 weeks.