title: Medium term outcome in Bell's palsy in children.
abstract: OBJECTIVE
  Bell's palsy is a non-life threatening disorder with important functional and psychosocial effects. While recent research has shown significant benefit from treatment with steroids in adults, there have been no conclusive studies demonstrating benefit in children. This study set out to explore the medium term resolution of symptoms in Bell's palsy presenting to the emergency department (ED).
  
  
  METHODS
  This was a retrospective cohort study of children attending an Irish paediatric ED with a diagnosis of Bell's palsy. Patients were identified via the ED database. The primary outcome measure was resolution at follow-up call (6-18 months after presentation). Secondary outcome measures were ED treatment, imaging and time to resolution of symptoms.
  
  
  RESULTS
  There were 48 presentations, involving 45 patients. Left and right-sided palsies were equally represented. Of these, 16 (33%) received prednisolone. MRI was performed in five cases (10%), four were normal and one did not change management. In follow-up telephone contact, of 35 presentations, 28 (80%, 95% CI 63% to 91%) had complete resolution, six (17%, 95% CI 7% to 34%) partial resolution to variable degrees and one patient showed no improvement. Of the 13 patients who had received prednisolone, nine (69%, 95% CI 39% to 91%) had complete resolution; of the 22 patients who were not treated with prednisolone 19 (86%, 95% CI 65% to 97%) had complete resolution (p=0.22).
  
  
  CONCLUSIONS
  The majority of children with Bell's palsy have complete resolution of the facial weakness. Steroid use is highly variable and warrants a placebo controlled randomised trial.
authors: Emergency Department, Children's University Hospital, Dublin, Ireland. roisinmcnamara@hotmail.com
authors: Roisin
authors: R
authors: McNamara
authors: Jennifer
authors: J
authors: Doyle
authors: Mary
authors: M
authors: Mc Kay
authors: Peter
authors: P
authors: Keenan
authors: Franz E
authors: FE
authors: Babl
mesh_terms: D020330:Bell Palsy / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007494:Ireland; D008279:Magnetic Resonance Imaging; D018908:Muscle Weakness / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone