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Medium term outcome in Bells palsy in children
Emergency Medicine Journal, 07/16/2012
McNamara R et al. – 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.
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 (6–18months after presentation).
- Secondary outcome measures were ED treatment, imaging and time to resolution of symptoms.
- 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).