Search Results (3)

Background/Objectives: 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. Methods: 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. Results: 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 (p = 0.024), with higher doses correlating with poorer outcomes (p = 0.022). Vitamin supplementation showed no significant impact. Conclusions: 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. Full article

(1) Introduction: This pilot study aimed to analyze neurofilament light chain levels in cerebrospinal fluid (cNfL) in a cohort of children with different acute nontraumatic neurological conditions. (2) Methods: This prospective observational cohort study consisted of 35 children aged 3 months to 17 years and was performed from November 2017 to December 2019. Patients’ clinical data were reviewed, and patients were assigned to the following groups: n = 10 (28.6%) meningitis, 5 (14.3%) Bell’s palsy, 7 (20.0%) febrile non-CNS infection, 3 (8.6%) complex febrile seizure, 4 (11.4%) idiopathic intracranial hypertension, and 6 (17.1%) others. cNfL levels were measured using a sensitive single-molecule array assay. (3) Results: The cNfL levels [median (range)] in children with meningitis were 120.5 pg/mL (58.1–205.4), in Bell’s palsy 88.6 pg/mL (48.8–144.5), in febrile non-CNS infection 103.9 pg/mL (60.1–210.8), in complex febrile seizure 56 pg/mL (53.2–58.3), and in idiopathic intracranial hypertension 97.1 pg/mL (60.1–124.6). Within the meningitis group, children with Lyme neuroborreliosis (LNB) had significantly higher cNfL concentrations (median 147.9 pg/mL; range 87.8–205.4 pg/mL) than children with enterovirus meningitis (72.5 pg/mL; 58.1–95.6 pg/mL; p = 0.048) and non-significantly higher cNfL levels when compared to Bell’s palsy (88.6 pg/mL; 48.8–144.5 pg/mL; p = 0.082). There was no correlation between cNfL levels and age. (4) Conclusions: Although the number of patients in this pilot study cohort is limited, higher cNfL levels in children with LNB compared to those with viral meningitis (significant) and Bell’s palsy (trend) may indicate the potential of cNfL as a biomarker in the differential diagnosis of pediatric meningitis and facial palsy. Full article

The prognosis of children with Bell’s palsy remains unclear due to its relatively low incidence, and thus, the small number of patients included in individual studies. To evaluate the prognosis of children with Bell’s palsy and identify the predictive value of specific factors that contribute to complete recovery, a retrospective cohort study was conducted of all patients with Bell’s palsy who visited the outpatient clinic of our university hospital between January 2005 and December 2020. We identified the parameters associated with a favorable recovery after 6 months in pediatric patients with Bell’s palsy. Factors recorded for each patient included age, sex, side affected by palsy, time between symptom onset and start of treatment, treatment methods, and the House–Brackmann grade (H–B) grade. The results of the multivariable analysis revealed that the lower degree of initial facial nerve paralysis presented as H–B grade II–IV was a significant favorable prognostic factor (OR: 3.86; 95% CI: 1.27–11.70; p < 0.05). Our results showed that the most important factor influencing the complete recovery of Bell’s palsy in children was the lower initial H–B grade at initial presentation. Full article