Children with condition that causes temporary facial paralysis can recover without treatment

Most children with a condition that causes a temporary weakness or paralysis of the muscles in the face recover without medication within six months, according to a new study.

The research, led by the Murdoch Children’s Research Institute and published in Neurology, found the steroid prednisolone does not significantly impact a child’s recovery from Bell’s palsy.

Murdoch Children’s Professor Franz Babl said while studies had shown steroid use in adults with Bell’s palsy helped improve symptoms by minimising facial nerve swelling and damage within the temporal bone, similar research hadn’t been available for children.

The randomised-controlled trial involved 187 participants, aged six months to 17 years, who presented to emergency departments (EDs) with Bell’s palsy. The study was staged in 11 ED’s in the Paediatric Research in Emergency Departments International Collaborative (PREDICT) research network in Australia and New Zealand. They were recruited within 72 hours after symptom onset and received 10 days of treatment with prednisolone or a placebo (no active drug).

The study found 57 per cent of those who didn’t take any medication recovered facial function at one month, 85 per cent at three months and 93 per cent at six months. For those assigned prednisolone, 49 per cent recovered at one month, 90 per cent at three months and 99 per cent at six months.  There were no serious side effects recorded during the trial, and the most common adverse reactions were temporary changes in behaviour and increased appetite.

Bell’s palsy, which causes half of the face to droop, is the third most common condition causing a sudden change in nerve function in children. In most cases, the exact cause of the facial weakness is unknown but may be related to a viral infection.

“The lack of evidence on the use of steroids in children with Bell’s palsy has led to variable practice in their treatment,” Professor Babl said. “Discovering that early treatment with prednisolone doesn’t hasten recovery will help GPs, emergency physicians and paediatricians in their discussion with affected families and make better informed decisions.”

Publication: Franz E Babl, David Herd, Meredith Borland, Amit Kochar, Ben Lawton, Jason Hort, Adam West, Shane George, Michael Zhang, Karthik Velusamy, Frank Sullivan, Ed Oakley, Andrew Davidson, Sandy M Hopper, John A Cheek, Robert Berkowitz, Stephen Hearps, Catherine L Wilson, Amanda Williams, Hannah Elborough, Donna Legge, B Pharm, Mark T Mackay, Katherine J Lee and Stuart R Dalziel on behalf of Paediatric Research in Emergency Departments International Collaborative (PREDICT). ‘Efficacy of Prednisolone for Bell Palsy in Children: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial,’ Neurology.
DOI: 10.1212/WNL.0000000000201164

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

Available for interview:

Professor Franz Babl, Murdoch Children’s Group Leader, Emergency

Media Contact:

Bridie Byrne
Murdoch Children’s Research Institute media manager                                                                                
+61 457 365 848

About Murdoch Children’s Research Institute

The Murdoch Children's Research Institute is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.

Funding:

The study was funded by a grant from the National Health and Medical Research Council (NHMRC, project grant GNT1078069), the Emergency Medicine Foundation (EMSS-312R26-2016-GEORGE) and the Perth Children’s Hospital Foundation project grant #9670. The PREDICT research network was part funded by an NHMRC Center of Research Excellence grant (GNT1058560), the Murdoch Children’s Research Institute, and the Victorian Government’s Operational Infrastructure Support program. FEB’s time was part funded by a grant from The Royal Children’s Hospital Foundation, and an NHMRC Practitioner Fellowship. SRD’s time was part funded by the Health Research Council of New Zealand (HRC13/556) and Cure Kids.