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儿童周围性面神经麻痹:临床表现、治疗及预后

Peripheral facial nerve palsy in children: clinical manifestations, treatment and prognosis.

作者信息

Bilge Serap, Mert Gülen Gül, Hergüner M Özlem, İncecik Faruk, Sürmelioğlu Özgür, Bilen Sevcan, Yılmaz Levent

机构信息

Department of Pediatric Neurology, Faculty of Medicine, Çukurova University, Adana, Turkey.

Department of Ear, Nose &Throat, Faculty of Medicine, Çukurova University, Adana, Turkey.

出版信息

Egypt J Neurol Psychiatr Neurosurg. 2022;58(1):152. doi: 10.1186/s41983-022-00596-1. Epub 2022 Dec 9.

Abstract

BACKGROUND

Sudden onset of unilateral weakness of the upper and lower muscles of one side of the face is defined as peripheral facial nerve palsy. Peripheral facial nerve palsy is often idiopathic and sometimes it could be due to infectious, traumatic, neoplastic, and immune causes. This study aimed to report the clinical manifestation, evaluation, and prognosis in children with peripheral facial nerve palsy.

METHODS

57 children under 18 years of age diagnosed with peripheral facial nerve palsy at Çukurova University, Balcalı Hospital, between January 2018 and September 2021, were included in the study.

RESULTS

The mean age of the children at the time of diagnosis was 9.6 ± 7, 4 years. Thirty-two (56.1%) of the patients were female and 25 (43.9%) were male. A total of 57 patients were diagnosed with peripheral facial nerve palsy and categorized into many groups by etiology: idiopathic Bell's palsy in 27 (47.5%), infectious in 11 (19.2%), traumatic in 6 (10.5%), and others (due to congenital, immune, neoplastic, Melkersson-Rosenthal syndrome, drug toxicity, and iatrogenic causes) in 13 (22.8%). Forty-six of the children achieved full recovery under oral steroids within 1-7 months. Four patients with acute leukemia, myelodysplastic syndrome, Mobius syndrome and trauma did not recover and two patients (schwannoma, trauma) showed partial improvement. Five patients could not come to follow-up control.

CONCLUSION

Peripheral facial nerve palsy is a rare condition in children with different causes. It could be idiopathic, congenital, or due to infectious, traumatic, neoplastic, and immune reasons. So, when a child presents with facial palsy, a complete clinical history and a detailed clinical examination are recommended. Giving attention to the red flag is very important. Peripheral facial nerve palsy in children is considered to have a good prognosis.

摘要

背景

一侧面部上下肌肉突然出现单侧无力被定义为周围性面神经麻痹。周围性面神经麻痹通常是特发性的,有时可能由感染、创伤、肿瘤和免疫因素引起。本研究旨在报告儿童周围性面神经麻痹的临床表现、评估及预后。

方法

纳入2018年1月至2021年9月期间在Çukurova大学Balcalı医院诊断为周围性面神经麻痹的57例18岁以下儿童。

结果

诊断时儿童的平均年龄为9.6±7.4岁。患者中32例(56.1%)为女性,25例(43.9%)为男性。共有57例患者被诊断为周围性面神经麻痹,并按病因分为多个组:特发性贝尔麻痹27例(47.5%),感染性11例(19.2%),创伤性6例(10.5%),其他(由于先天性、免疫性、肿瘤性、梅克尔森 - 罗森塔尔综合征、药物毒性和医源性原因)13例(22.8%)。46例儿童在口服类固醇药物治疗1至7个月内完全康复。4例患有急性白血病、骨髓增生异常综合征、莫比乌斯综合征和创伤的患者未康复,2例患者(神经鞘瘤、创伤)有部分改善。5例患者未进行随访。

结论

周围性面神经麻痹在儿童中是一种病因各异的罕见疾病。它可能是特发性、先天性的,或由感染、创伤、肿瘤和免疫因素引起。因此,当儿童出现面神经麻痹时,建议进行完整的临床病史采集和详细的临床检查。关注警示信号非常重要。儿童周围性面神经麻痹被认为预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b45b/9734354/e1a82381a49e/41983_2022_596_Fig1_HTML.jpg

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