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Published on: March 1, 2015
Prognostic Factors Associated With Recovery in Children With Bell's Palsy
Elif Karatoprak1, Sila Yilmaz1
1Department of Pediatric Neurology, Faculty of Medicine, Medeniyet University, Istanbul, Turkey.
Insights
Bell's palsy in children has an excellent prognosis, with most recovering fully. Early steroid treatment within 24 hours and a House-Brackmann Facial Nerve Grading System grade of 2 or 3 on day 10 predict faster recovery in pediatric Bell's palsy patients.
Area of Science:
- Pediatric Neurology
- Otolaryngology
- Dermatology
Background:
- Bell's palsy is an idiopathic facial nerve paralysis affecting children.
- Understanding prognostic factors is crucial for managing pediatric Bell's palsy.
Purpose of the Study:
- To determine the prognosis of Bell's palsy in children.
- To identify factors influencing early recovery from pediatric Bell's palsy.
Main Methods:
- Retrospective analysis of 102 children diagnosed with Bell's palsy.
- Review of demographic data, House-Brackmann Facial Nerve Grading System (HBGS) scores, and steroid treatment details.
- Comparison of early (<1 month) versus late (>1 month) recovery groups.
Main Results:
- Complete recovery observed in 99% of pediatric patients.
- Early recovery was significantly associated with steroid treatment dosage and onset time (P=.04, P=.035).
- House-Brackmann Facial Nerve Grading System grade on day 10 was a significant predictor (P=.001).
Conclusions:
- Pediatric Bell's palsy generally has a very good prognosis.
- Early steroid administration (within 24 hours) and favorable HBGS scores on day 10 are key predictors of rapid recovery.
- Neutrophil-to-lymphocyte ratio and red blood cell distribution width were not predictive of early recovery.
Objectives:
The aim of the study was to determine the prognosis of children with Bell's palsy and analyze the prognostic factors affecting early recovery.
Methods:
The records of children with a diagnosis of Bell's palsy were retrospectively analyzed. Demographic and clinical features including age, gender, House-Brackmann Facial Nerve Grading System House-Brackmann Grading Scale (HBGS) grade at admission and follow-up, and the dosage and onset of steroid treatment were reviewed. Laboratory findings such as red blood cell distribution width and neutrophil-to-lymphocyte ratio were noted. The patients who were recovered within the first month (early recovery) were compared with the patients who were recovered after first month (late recovery) in terms of demographic, clinical characteristics, laboratory findings and treatment modalities in order to determine the risk factors affecting early recovery.
Results:
A total of 102 children (65 girls and 37 boys) with a mean age of 10.37 ± 4.2 years were included in the study. The complete recovery was detected in 101 children (%99) with Bell's palsy. Statistically significant difference was found in terms of dosage and time of onset of steroid treatment (P = .04, P = .035, respectively) and House-Brackmann Facial Nerve Grading System grade on the 10th day (P = .001) between the early and late recovery groups.
Conclusion:
The prognosis of Bell's palsy in children was very good. The prognostic factors affecting the early recovery were being House-Brackmann Facial Nerve Grading System grade 2 or 3 on the 10th day and receiving steroid treatment in the first 24 hours. Neutrophil-to-lymphocyte ratio and red blood cell distribution width were not found to be predictive factors for early recovery.
