Magnetic resonance imaging of the facial nerve in children with idiopathicfacial paralysis

The role of gadolinium-enhanced MRI (Gd-MRI) in the diagnosis of idiopathic facial paralysis (IFP) in children is not well defined. Fourteen children with IFP were evaluated to assess the use of Gd-MRI for the presence and pa ttern of enhancement and its usefulness in predicting the recovery of facia l function. Six of 14 children had enhancement of the facial nerve on Gd-MR I, whereas 8 had none. Enhancement was noted in the tympanic, mastoid, and most commonly in the distal intracanalicular and labyrinthine segments. The average time from onset of paresis to recovery in patients with enhancemen t was 19.3 weeks, whereas in those with no enhancement, mean recovery time was 9.5 weeks (P = 0.003, t test). All 14 patients eventually had recovery to House-Brackmann grade I or II. Gd-MRI is not required for all children w ith IFP but may yield information about the time course of recovery of faci al function.