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Do oral steroids aid recovery in children with Bell's palsy?
Abdul Qader Ismail1, Oluwaseyi Alake2, Chetana Kallappa2
1Paediatric Department, Good Hope Hospital, Sutton Coldfield, Birmingham, England aqt.ismail@bnc.oxon.org.
Insights
Steroids offer no significant benefit for pediatric Bell's palsy, as all children recovered regardless of treatment. Further research is needed for severe cases to avoid omitting potentially beneficial therapies.
Area of Science:
- Pediatric Neurology
- Otolaryngology
Background:
- Bell's palsy affects children, causing facial nerve paralysis.
- Steroid efficacy in pediatric Bell's palsy remains debated.
- Evidence suggests limited benefit of steroids in this population.
Purpose of the Study:
- To evaluate the effectiveness of steroid treatment in children with Bell's palsy.
- To compare symptom duration in treated versus untreated pediatric Bell's palsy patients.
Main Methods:
- Retrospective longitudinal study of 100 children over 12 years.
- Analysis of medical records for facial nerve palsy diagnoses.
- Comparison of symptom resolution intervals between steroid-treated and untreated Bell's palsy patients.
Main Results:
- 79 children diagnosed with Bell's palsy; all achieved recovery.
- No statistically significant difference in symptom duration between treated (median 5 weeks) and untreated (median 6 weeks) groups.
- P-value of .86 indicates no significant difference.
Conclusions:
- All children with Bell's palsy recovered irrespective of steroid treatment.
- Current evidence does not support routine steroid use in pediatric Bell's palsy.
- Further research is warranted for severe Bell's palsy cases to guide treatment decisions.
Abstract:
There is growing evidence that steroids are not beneficial for treatment of paediatric patients with Bell's palsy. To investigate, we conducted a retrospective longitudinal study examining notes of 100 children, over 12 years coded for facial nerve palsy. Of the 79 diagnosed with Bell's palsy, all recovered, and for 46 patients we had data on interval from onset of symptoms to resolution (median duration in treated group = 5 weeks, range = 39; median duration in untreated group = 6 weeks, range = 11; P = .86). From our results, we conclude that all children with Bell's palsy recovered, with or without steroid treatment, with no statistically significant difference in symptoms duration. Complications of unresolved Bell's palsy can have important long-term functional and psychosocial consequences. Therefore, we need further research on use of steroids in children with complete/severe cases; it would be a shame to omit treatment due to "absence of evidence" rather than "evidence of absence."
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