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Published on: March 1, 2015
Clinical Characteristics and the Prognostic Factors of Acute Peripheral Facial Palsy in Children
Young-Soo Chang1, Su Jeong You2
1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul 01757, Republic of Korea.
Insights
Pediatric acute peripheral facial palsy (PFP) generally has a good prognosis. Younger children with PFP are more prone to recurrence, and complete facial palsy indicates a longer recovery period.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Otolaryngology
Background:
- Acute peripheral facial palsy (PFP) is a common condition in children.
- Understanding the clinical characteristics and outcomes of pediatric PFP is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics of children diagnosed with acute peripheral facial palsy (PFP).
- To analyze factors influencing the recovery period and recurrence rates in pediatric PFP.
Main Methods:
- Retrospective analysis of 109 children under 19 treated for acute PFP (January 2009 - July 2023).
- Patients categorized by initial severity using House-Brackmann (H-B) grades (≤III incomplete, ≥IV complete).
- Recovery period defined as time to achieve H-B grade I or II.
Main Results:
- Younger age was associated with PFP recurrence (p=0.001).
- Initial PFP severity significantly impacted recovery time (complete palsy: 75.1 days vs. incomplete palsy: 26.7 days; p=0.001).
- No significant association found between age, treatment delay, etiology, or antiviral use and recovery period.
Conclusions:
- Pediatric acute PFP demonstrates a favorable prognosis.
- Younger patients are at higher risk for PFP recurrence.
- Complete PFP requires a significantly longer recovery duration compared to incomplete PFP.
Abstract:
Background and Objectives: This study aimed to investigate the clinical characteristics of children with acute peripheral facial palsy (PFP) in a single medical center. Materials and Methods: We conducted a retrospective analysis of children under 19 years of age treated for acute PFP between January 2009 and July 2023. A total of 109 patients were enrolled, and 7 patients showed recurrence. Of all the patients included, only 68 patients followed up for over 1 month (the follow-up cohort), in whom clinical outcomes were analyzed. The recovery period was calculated as the duration between the first day of facial palsy development and the last follow-up day on which the patient achieved a House-Brackmann (H-B) grade of I or II. Patients were categorized into two groups depending on the initial severity of their facial palsy using the H-B grade: "incomplete palsy", defined as H-B grade ≤III; and "complete palsy", defined as H-B grade ≥IV. Results: When comparing the group of patients which had recurrence (n = 7) and the group with no recurrence (n = 91), the age in the group with recurrence was younger (79.1 ± 29.9 vs. 143.8 ± 52.5, months, p = 0.001, Mann-Whitney U test). In the follow-up cohort, four (5.9%) patients continued to have mild facial palsy (H-B grade II). Age, the time lag between the onset of palsy and treatment initiation, the type of etiology and the use of antiviral agents were not associated with the recovery period. The initial severity of facial palsy was significantly associated with the recovery period (incomplete palsy group 26.7 ± 18.4 days, complete palsy group 75.1 ± 96.0 days, unstandardized regression coefficient = 50.5, p = 0.001). Conclusions: The outcome of acute PFP in children showed a good prognosis. The recurrence of PFP was observed in younger patients. An initial severity of "complete palsy" entailed a significantly longer recovery period.
