Di Sarno Lorenzo, Caroselli Anya, Graglia Benedetta, Causio Francesco Andrea, Gatto Antonio, Pansini Valeria, Di Vizio Natalia Camilla, Chiaretti Antonio
Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.
Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Clin Med. 2024 Dec 27;14(1):79. doi: 10.3390/jcm14010079.
Bell's palsy (BP) is a neurological disorder characterized by sudden unilateral peripheral facial paralysis. The etiology in children remains largely unknown, and standardized management strategies are lacking. The aim of this retrospective cohort study is to evaluate clinical features, laboratory markers, and therapeutic options associated with recovery to identify potential prognostic factors and validate therapeutic strategies, with a particular focus on the role of corticosteroids and vitamin supplementation. A retrospective cohort study was conducted on 88 children (aged < 18 years) diagnosed with BP at a single tertiary care center between 2010 and 2023. Clinical data, including House-Brackmann (HB) scores, were collected at baseline and at a two-month follow-up. Statistical analysis was performed to assess the associations between demographic, clinical, and laboratory parameters with recovery outcomes. Prednisone and vitamin supplementation were administered at the discretion of the treating pediatrician. In total, 81.8% of patients achieved complete recovery at 2-month follow-up (HB grade 1). No significant associations were found between recovery and gender, age, side of paralysis, initial HB grade, or laboratory markers. However, the use of prednisone was associated with a higher rate of incomplete recovery ( = 0.024), with higher doses correlating with poorer outcomes ( = 0.022). Vitamin supplementation showed no significant impact. Our findings suggest that corticosteroid therapy may not be a disease-modifying factor that ultimately influences outcomes in pediatric BP. Further large-scale studies are needed to define evidence-based protocols for managing pediatric BP.
贝尔麻痹（BP）是一种以突发单侧周围性面瘫为特征的神经系统疾病。儿童患者的病因在很大程度上仍不明确，且缺乏标准化的管理策略。这项回顾性队列研究的目的是评估与恢复相关的临床特征、实验室指标和治疗选择，以确定潜在的预后因素并验证治疗策略，特别关注皮质类固醇和维生素补充剂的作用。对2010年至2023年期间在一家三级医疗中心确诊为BP的88名18岁以下儿童进行了回顾性队列研究。在基线和两个月随访时收集包括House-Brackmann（HB）评分在内的临床数据。进行统计分析以评估人口统计学、临床和实验室参数与恢复结果之间的关联。泼尼松和维生素补充剂由治疗儿科医生酌情使用。在2个月的随访中，总共81.8%的患者实现了完全恢复（HB 1级）。未发现恢复与性别、年龄、面瘫侧别、初始HB分级或实验室指标之间存在显著关联。然而，使用泼尼松与不完全恢复率较高相关（P = 0.024），剂量越高，预后越差（P = 0.022）。维生素补充剂未显示出显著影响。我们的研究结果表明，皮质类固醇治疗可能不是最终影响儿童BP预后的疾病改善因素。需要进一步开展大规模研究来确定基于证据的儿童BP管理方案。
