Facial palsy in children: emergency department management and outcome.
OBJECTIVE
To describe the characteristics of children who present to an emergency department (ED) with facial palsy and determine the association of outcome with etiology, degree of initial paralysis, and ED management.


METHODS
This was a retrospective cohort study of children who presented to an ED with facial nerve paralysis (FNP).


RESULTS
There were 85 patients with a mean age of 8.0 (SD, 6.1) years; 60% (n = 51) of the patients were male, and 65.9% (n = 56) were admitted to the hospital. Bell palsy (50.6%) was the most common etiology followed by infectious (22.4%), traumatic (16.5%), congenital (7.1%), and neoplastic etiologies (3.5%). Patients with Bell palsy had shorter recovery times (P = 0.049), and traumatic cases required a longer time for recovery (P = 0.016). Acute otitis media (AOM)-related pediatric FNP had shorter recovery times than non-AOM-related cases (P = 0.005) in infectious group. Patients given steroid therapy did not have a shorter recovery time (P = 0.237) or a better recovery (P = 0.269). There was no difference in recovery rate of pediatric patients with Bell palsy between hospitalization or not (P = 0.952).


CONCLUSIONS
Bell palsy, infection, and trauma were most common etiologies of pediatric FNP. Recovery times were shorter in pediatric patients with Bell palsy and AOM-related FNP, whereas recovery took longer in traumatic cases. Steroid therapy did not seem beneficial for pediatric FNP. Hospitalization is not indicated for pediatric patients with Bell palsy.
Wang
Cheng-Hsien
CH
Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Chang
Yu-Che
YC
Shih
Hong-Mo
HM
Chen
Chun-Yu
CY
Chen
Jih-Chang
JC
D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D020330:Bell Palsy / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000150:complications; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005158:Facial Paralysis / Q000151:congenital / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010033:Otitis Media / Q000150:complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014777:Virus Diseases / Q000150:complications
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents