# Clinical Characteristics and the Prognostic Factors of Acute Peripheral Facial Palsy in Children

## TL;DR

This study examines the clinical features and recovery of acute facial palsy in children, finding that younger age and initial severity are linked to recurrence and longer recovery.

## Contribution

The study identifies initial severity and younger age as key prognostic factors in pediatric acute peripheral facial palsy.

## Key findings

- Younger patients are more likely to experience recurrence of facial palsy.
- Initial severity of facial palsy significantly affects recovery duration.
- Most children with acute peripheral facial palsy have a good prognosis.

## Abstract

Background and Objectives: This study aimed to investigate the clinical characteristics of children with acute peripheral facial palsy (PFP) in a single medical center. Materials and Methods: We conducted a retrospective analysis of children under 19 years of age treated for acute PFP between January 2009 and July 2023. A total of 109 patients were enrolled, and 7 patients showed recurrence. Of all the patients included, only 68 patients followed up for over 1 month (the follow-up cohort), in whom clinical outcomes were analyzed. The recovery period was calculated as the duration between the first day of facial palsy development and the last follow-up day on which the patient achieved a House–Brackmann (H–B) grade of I or II. Patients were categorized into two groups depending on the initial severity of their facial palsy using the H–B grade: “incomplete palsy”, defined as H–B grade ≤III; and “complete palsy”, defined as H–B grade ≥IV. Results: When comparing the group of patients which had recurrence (n = 7) and the group with no recurrence (n = 91), the age in the group with recurrence was younger (79.1 ± 29.9 vs. 143.8 ± 52.5, months, p = 0.001, Mann–Whitney U test). In the follow-up cohort, four (5.9%) patients continued to have mild facial palsy (H–B grade II). Age, the time lag between the onset of palsy and treatment initiation, the type of etiology and the use of antiviral agents were not associated with the recovery period. The initial severity of facial palsy was significantly associated with the recovery period (incomplete palsy group 26.7 ± 18.4 days, complete palsy group 75.1 ± 96.0 days, unstandardized regression coefficient = 50.5, p = 0.001). Conclusions: The outcome of acute PFP in children showed a good prognosis. The recurrence of PFP was observed in younger patients. An initial severity of “complete palsy” entailed a significantly longer recovery period.