Peripheral facial palsy in children. A cerebrospinal fluid study

Area of Science:

• Neurology
• Pediatrics
• Infectious Diseases

Background:

• Acute peripheral facial palsy, commonly known as Bell's palsy, affects facial nerve function.
• While often idiopathic, underlying causes and central nervous system (CNS) involvement are considered, particularly in pediatric cases.

Purpose of the Study:

• To investigate clinical, blood, and cerebrospinal fluid (CSF) findings in children and adults with acute peripheral facial palsy.
• To determine the prevalence of subclinical CNS pathology in pediatric facial palsy and assess recovery outcomes.

Main Methods:

• Clinical examination of twelve patients (seven children, five adults) with acute peripheral facial palsy.
• Analysis of routine blood tests and serological tests for blood and CSF.
• Cerebrospinal fluid (CSF) analysis, including cell counts.

Main Results:

• Routine blood and CSF serological tests were normal in all patients.
• CSF analysis revealed increased mononuclear white cells in all children, despite minimal meningitis signs.
• Two patients had normal CSF; children showed excellent recovery within three months, unlike adults.

Conclusions:

• Acute peripheral facial palsy can be a manifestation of generalized disorders with subclinical CNS pathology.
• In children presenting with acute peripheral facial palsy, a lumbar puncture is advisable, even in the absence of overt meningitis symptoms.
• Pediatric patients with acute peripheral facial palsy demonstrate a favorable prognosis with complete recovery.