Bell's palsy in children: relationship between electroneurography findings and prognosis in comparison with adults

Otol Neurotol. 2011 Dec;32(9):1554-8. doi: 10.1097/MAO.0b013e31823556ae.

Abstract

Objectives: To investigate the correlation between electroneurography (ENoG) findings and the prognosis of Bell's palsy in children compared with adults.

Methods: Twenty-two children and 92 adults with Bell's palsy who underwent ENoG between 8 days and 4 weeks from the onset of symptoms were retrospectively enrolled. The time to maximal recovery and rate of favorable recovery (House-Brackmann grade I or II) was assessed. Children (C) and adults (A) were further subdivided into low (<10%) or high (≧10%) subgroups according to their ENoG values (affected versus unaffected side) at initial evaluation. The numbers in each subgroup were as follows: C-low (n = 8), A-low (n = 21), C-high (n = 14), and A-high (n = 71).

Results: Of the 22 children assessed, 2 of the 4 patients who showed a total loss of evoked potentials on the affected side (0% ENoG value) exhibited an unfavorable recovery. The remaining 20 patients achieved a favorable recovery eventually. Patients in group C-low reached a maximal recovery of facial movement significantly later than those in group C-high (p < 0.001). Time to maximal recovery of facial movement in group A-low was later than that in group C-low, although the difference was not statistically significant (p = 0.15). The patients in group A-high reached a maximal recovery significantly later than those in group C-high (p < 0.05).

Conclusion: Bell's palsy seems to recover earlier in children than adults when matched for severity. The presence of an identifiable response in ENoG, irrespective of its amplitude, may indicate a favorable recovery of facial movement in children.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Bell Palsy / diagnosis*
  • Bell Palsy / physiopathology
  • Child
  • Child, Preschool
  • Electrodiagnosis
  • Evoked Potentials / physiology
  • Facial Nerve / physiopathology*
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies