ACUTE PERIPHERAL FACIAL-NERVE PALSY IN CHILDREN - ETIOLOGY AND PROGNOSIS

Background. As facial nerve palsy is usually of sudden onset and of ob scure etiology, a survey of large series may provide new information. Patients and methods. The files of 40 children suffering from acute fa cial nerve palsy seen in 3 pediatric and 1 otorhinolaryngologic (ORL) departments between 1980 and 1990 were analysed. Patients with congeni tal palsy and those with paralysis that appeared after injury or in th e course of acute or chronic disease (otitis media, tumor) were exclud ed from the study. The children were 9 months- 16 years old (mean: 7 y ear 1 month). There were 22 left and 18 right facial nerve palsies. Th e palsy was moderate in 17 children, severe in 15, and total in 5. Eti ologic factors (viral serologic studies, CSF examination), ORL studies and electromyogram of the facial nerve were analyzed in the majority of cases. Corticosteroids were used in 30 patients. Results. A viral e tiology was suspected and/or confirmed in 13 children; abnormalities w ere seen in 6 of the patients who underwent lumbar puncture. A familia l facial nerve palsy was seen in 1 case and kidney disease in 2 cases. 23 cases appeared to be idiopathic. A moderate permanent residual wea kness was seen in only 4 children. The mean time for recovery was 32 d ays (4-140 days). Corticosteroids did not influence the incidence of c omplete recovery, but decreased the time for recovery (26 versus 37 da ys) only in the patients who were treated before the 3rd day of the di sease. Patients with idiopathic palsy recovered 23 days before thore w ith viral etiology. Conclusions. Idiopathic and post-viral facial nerv e palsies seem to have an excellent prognosis. Corticosteroids seem to have no effect although there is some evidence of benefit when treatm ent is begun early.