Atypical Bell's palsy in a child under 3 years

*Correspondence: [e-mail].

Abstract

Case Presentation: S.B.V.M., female, 2 years and 6 months old, white, attended the Pediatric Emergency Room, with a history of cough, runny nose and intermittent febrile episodes, of a prolonged nature and oscillation of clinical improvement, for about 30 days, evolving with facial paralysis peripheral. Upon admission, he presented with left facial paralysis and ipsilateral palpebral ptosis. Patient with a history of prematurity did not undergo routine follow-up. He had a head circumference of 50.5 cm (score 97), megalencephaly, questioning other associated causes. Cranial Computed Tomography showed dilatation of the supra and infratentorial ventricular system, the etiology of which remains to be clarified. Type 1 blood and urine laboratory tests showed leukocytosis and associated bacteriuria. After being medicated with prednisone 1mg/kg/day and ceftriaxone 100mg/kg/day, the patient had improvement of symptoms, with complete regression of paralysis and without other types of complications, not requiring a hydrocephalus approach.

Discussion: Peripheral Facial Palsy or Bell's is a disease clinically characterized by the involvement of the 7th cranial nerve, acutely, relating to pain complaints such as in the mastoid region and resulting in complete or partial paralysis of facial movements. It can be triggered by several causes, from viral infections as well as developing idiopathically. The diagnosis is made by the clinic and may make use of complementary tests such as computed tomography and nuclear magnetic resonance. Study carried out with the objective of reporting a case of Bell's Palsy, caused by the viral form, is increasingly relevant in pediatric observations, as it is uncommon in the age group described. In this work, radiological study, direct contact with the patient and medical record review were carried out.

Final Comments: Bell's Palsy is a rare syndrome in children, mainly under 10 years of age and its diagnosis has important therapeutic implications and good prognosis, due to the reversibility of the lesions with adequate and timely treatment. On the other hand, if not treated correctly, it can evolve with complications and/or sequelae. In the case of the patient in this report, it was possible to detect clinical signs early, reversing the lesions, with a favorable outcome of the condition through rapid control of the evolution of facial paralysis.

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Artikel online veröffentlicht:
12. Mai 2025