PEDBASE.org - The Pediatric Database - Detailed information of BELL'S PALSY

BELL'S PALSY

DEFINITION:

An acute unilateral facial nerve palsy.

EPIDEMIOLOGY:

incidence: common
age of onset:
- infancy to adolescence
risk factors:

1. Systemic Viral Infections

EBV in about 20% of cases
HSV, mumps

2. Systemic Spirochete Infections

Lyme Disease

PATHOGENESIS:

1. Background

viral or spirochete infection -> postinfectious allergic or immune demyelinating facial neuritis -> abrupt onset of clinical manifestations about 2 weeks after infection

CLINICAL FEATURES:

1. Neurological Manifestations (on affected side)

paresis of upper and lower face
drop of corner of mouth
unable to close eye -> exposure keratitis at night
loss of taste on anterior 2/3rd's of tongue in 50% of cases

INVESTIGATIONS:

1. Electrophysiology

of facial nerve may show signs of a neuropathy and regeneration

MANAGEMENT:

1. Supportive

protection of cornea with methylcellulose eye drops or an ocular lubricant
no role for steroids or surgical decompression of the facial canal

2. Prognosis

85% recover spontaneously
10% mild facial weakness
5% permanent severe facial weakness

Pediatric Database - BELL'S PALSY

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