Acute facial palsy in children--a 2-year follow-up study with focus on Lyme neuroborreliosis.
OBJECTIVE
Acute facial palsy in children is believed to be a rather benign neurological condition. Follow-up-studies are sparse, especially including a thorough otoneurological re-examination. The aim of this study was to examine children with a history of facial palsy in order to register the incidence of complete recovery and the severity and nature of sequelae. We also wanted to investigate whether there was a correlation between sequelae and Lyme Borreliosis, treatment or other health problems.


METHODS
Twenty-seven children with a history of facial palsy were included. A re-examination was performed by an Ear-Nose-Throat (ENT) specialist 1-2.9 years (median 2) after the acute facial palsy. The otoneurological examination included grading the three branches of the facial nerve with the House-Brackman score, otomicroscopy and investigation with Frenzel glasses. A paediatrician interviewed the families. Medical files were analysed.


RESULTS
The incidence of complete recovery was 78% at the 2-year follow-up. In six out of 27 children (22%), the facial nerve function was mildly or moderately impaired. Four children reported problems with tear secretion and pronunciation. There was no correlation between sequelae after the facial palsy and gender, age, related symptoms, Lyme neuroborreliosis (NB), treatment, other health problems or performance.


CONCLUSIONS
One fifth of children with an acute facial palsy get a permanent dysfunction of the facial nerve. Other neurological symptoms or health problems do not accompany the sequelae of the facial palsy. Lyme NB or treatment seems to have no correlation to clinical outcome. Factors of importance for complete recovery after an acute facial palsy are still not known.
Division of Pediatrics, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, University Hospital, SE-581 85, Linköping, Sweden. barbro.hedin-skogman@lio.se
B Hedin
BH
Skogman
S
S
Croner
L
L
Odkvist
D000293:Adolescent; D001898:Borrelia / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005154:Facial Nerve / Q000503:physiopathology; D005158:Facial Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors