[Bell's palsy: diagnostic and therapeutical trial in childhood].
Bell's palsy is caused by a nuclear and/or infranuclear lesion of the facial nerve, producing an ipsilateral deficit of the facial muscles. The etiology is unknown. Bell's palsy has a frequency of 20:100000 individuals/year, a familiarity of 1-2% of cases, and a recurrence rate of 9% of cases. We studied 33 children (mean age 9.1 years) admitted to our Division during the period 1991-1994 because of Bell's palsy. We propose our personal diagnostic and therapeutical trial: in every patient a full neurological and otoscopic examination, and an audioimpedenzometric test. Treatment is then commenced with prednisone (1 mg/kg/day p.o. for 5-10 days and gradual reduction in 5 days), vitamins B1, B6 and B12 p.o. for 30 days, and local treatment with artificial tears, and occlusive bandage at nighttime until the lagophthalmus is resolved. Electromyography-electroneurography, and brain CT-scan are carried out after 15 days and 21 days respectively of treatment, if neurological deficit is unchanged. 80 to 90% of patients are reported to recover spontaneously from Bell's palsy. With our approach we achieved a 100% recovery rate within an average of 3 weeks (range: 1 week to 5 months).
Micheli
R
R
Divisione di Neuropsichiatria Infantile, Azienda USSL 18, Spedali Civili, Brescia.
Telesca
C
C
Gitti
F
F
Giordano
L
L
Perini
A
A
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005154:Facial Nerve / Q000503:physiopathology; D005158:Facial Paralysis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012075:Remission, Spontaneous; D012189:Retrospective Studies
D000893:Anti-Inflammatory Agents; D011241:Prednisone