Efficacy of steroid treatment and identification of prognostic factors in idiopathic peripheral facial nerve palsy in children

Year 2022, , 660 - 671, 30.06.2022

Habibe Koç Uçar , Esra Sarıgeçili

https://doi.org/10.17826/cumj.1053502

Cited By: 1

Abstract

Purpose: The aim of the study is intended to investigate the etiology and clinical features of children with idiopathic peripheral facial palsy (IPFP) and to identify probable prognostic factors. It is also intended to investigate corticosteroid therapy and compare its efficacy.
Materials and Methods: A total of 80 patients with newly diagnosed IPFP were included in the study. Demographic, clinical features and laboratory findings including age, gender, House Brackmann Facial Nerve Grading System (HBGS) grade at admission and follow-up, and the dosage and onset of steroid treatment were reviewed. We assigned our patients to 3 groups: Group 1: Patients given 1 mg/kg oral steroid treatment (1 mg/kg/day oral prednisolone). Group 2: Patients given 2 mg/kg oral steroid treatment (2 mg/kg/day oral prednisolone), and Group 3: Patients who did not receive oral steroid treatment.
Results: A total of 80 children (41 girls and 39 boys) with a median age of 11 years were included in the study. The complete recovery was detected in %78,8(n:63) with IPFP. Of all patients, 78.8% (n=63) showed complete recovery. Admission after more than 24 hours was found to reduce the likelihood of ER by 10 times (1/0.10), while patients with HBGS grade of 5 were found to be 33.3 times (1/0.03) less likely to achieve ER than patients with HBGS grades of 2 to 3. Finally, steroid treatment at 2 mg/kg/d increased the probability of early recovery by 8.38 times.
Conclusion: The prognosis of IPFP in children was very good. The prognostic factors affecting the early recovery were being HBGS grade 2 or 3 on the 21th day and receiving steroid treatment in the first 24 hours and 2 mg/kg/d dose.

Keywords

Idiopathic peripheral facial palsy (IPFP), bell’s palsy, children, prognosis

Çocuklarda idiyopatik periferik fasiyal sinir paralizisinde steroid tedavisinin etkinliği ve prognostik faktörlerin belirlenmesi

Abstract

Amaç: Bu çalışmanın amacı, idiyopatik periferik fasiyal sinir paralizisi (IPFP) çocukların etiyolojisi, klinik özelliklerini araştırmak ve olası prognostik faktörleri belirlemektir. Bununla birlikte kortikosteroid tedavisinin etkinliğini incelemek ve karşılaştırmaktır.
Gereç ve Yöntem: Çalışmaya yeni tanı konmuş IPFP'li toplam 80 hasta dahil edildi. Başvuru ve takipte yaş, cinsiyet, House Brackmann Facial Nerve Grading System (HBGS) derecesi, steroid tedavisinin dozu ve başlangıcı gibi demografik, klinik özellikler ve laboratuvar bulguları gözden geçirildi. Hastalarımızı 3 gruba ayırdık: Grup 1: 1 mg/kg oral steroid tedavisi (1 mg/kg/gün oral prednizolon) verilen hastalar. Grup 2: 2 mg/kg oral steroid tedavisi (2 mg/kg/gün oral prednizolon) verilen hastalar ve Grup 3: Oral steroid tedavisi almayan hastalar.
Bulgular: Çalışma popülasyonu yaş ortalaması 11 olan 80 (41 kız,39 erkek) hastadan oluşmaktadır. IPFP ile %78,8(n:63) oranında tam iyileşme tespit edildi. Tüm hastaların %17.5'i tama yakın iyileşme gösterdi. Buna göre; 24 saat üzeri başvuru erken iyileşmeyi 10 kat (1/0,10) azalttığı, başvuru HBGS grade 5 olanların grade 2-3 olanlara kıyasla 33,3 kat (1/0,03) daha az erken iyileşme olasılığına sahip olduğu ve 2 mg/kg/g streoid tedavi alımının erken iyileşme olasılığını 8,38 kat arttırdığı saptandı.
Sonuç: Çocuklarda IPFP prognozu çok iyiydi. Erken iyileşmeyi etkileyen prognositik faktörler 21. günde HBGS derece 2 veya 3 olması ve ilk 24 saatte ve ve 2 mg/kg/g doz steroid tedavisi almasıydı.

Keywords

İdiyopatik periferik yüz felci (IPFP), Bell felci, çocuklar, prognoz

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