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Outcome of peripheral facial palsy in children - a catamnestic study
Felicia D Drack1, Markus Weissert
1Ostschweizer Kinderspital, Claudiusstrasse 6, 9006 St.Gallen, Switzerland. felicia.drack@kispisg.ch
Insights
Neuroborreliosis is a common cause of pediatric peripheral facial palsy (PFP), especially in summer and fall. Most children recover fully from PFP, often without steroid treatment, with only slight residual symptoms.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Acute peripheral facial palsy (PFP) in children has distinct characteristics compared to adults.
- Limited research exists on pediatric PFP, despite differing etiologies, therapies, and prognoses.
- This study addresses the gap in understanding PFP specifically in pediatric populations.
Purpose of the Study:
- To investigate the causes, treatments, and outcomes of acute peripheral facial palsy in children.
- To identify common etiologies and recovery rates in pediatric PFP cases.
- To analyze the impact of neuroborreliosis and idiopathic PFP on recovery.
Main Methods:
- Retrospective analysis of 84 children (10 months to 16 years) with PFP treated between 1998-2007.
- Data collection included etiology, diagnostics, therapy, and outcomes via medical records and questionnaires.
- Recovery was assessed using the House-Brackmann (HB) scale, with follow-up documentation for residual symptoms.
Main Results:
- Neuroborreliosis (NB) was the most frequent cause (31%), particularly from June to November (53.3% of NB cases).
- Idiopathic PFP (IPFP) accounted for 60.7% of cases; steroids were administered to only 4 IPFP patients.
- 89.3% of children achieved complete recovery (HB-Grade I); 10.7% had slight residual symptoms (HB-Grade II).
Conclusions:
- Neuroborreliosis is a significant cause of pediatric PFP, with seasonal variations.
- Children with borreliosis-related PFP demonstrated higher recovery rates compared to those with otitis media or IPFP.
- The majority of pediatric PFP cases resolve completely with minimal residual effects, irrespective of steroid treatment.
Background:
Even though the etiologies, therapies and prognoses of acute peripheral facial palsy (PFP) differ among children and adults, not many studies focus on children.
Methods:
We performed a retrospective study of 84 children, aged 10 months to 16 3/12 years, who were seen at the Children's Hospital of Eastern Switzerland between 1998 and 2007 due to PFP. Data about etiology, diagnostics and therapy were gathered from medical files, the outcome by questionnaires. Among 9 patients with residual symptoms, 6 returned for a follow-up visit and the results were documented with photographs. Recovery was graded by the House-Brackmann scale.
Results:
There were 83 unilateral and 1 bilateral case(s) of FP; neuroborreliosis (NB) causing 26 cases (31.0%), other infections 6 cases (7.1%) and toxicity of methotrexat 1 case (1.2%); 51 cases (60.7%) were classified as idiopathic (IPFP). Between the months June and November, the number of cases with NB rose to 53.3%, while there was no case between the months of January and April. Only 4 patients with IPFP received steroids. 75 patients (89.3%) recovered completely (HB-Grade I). 9 patients (10.7%) showed slight residual symptoms (HB-Grade II). Of these, 6 had IPFP, 1 had NB and 2 had otitis media (OM).
Discussion:
Almost a third of all palsies were caused by NB; during summer and fall, NB accounted for over half the cases. Patients with borreliosis showed a higher recovery rate than those with OM or IPFP. Almost 90% of the patients investigated recovered completely, even without steroid treatment. Residual symptoms were slight.
