Demographic and Clinical Features of Pediatric Bell's Palsy: A 26-Year Experience at a Tertiary Care Hospital in Riyadh.

BACKGROUND: Bell's palsy is the most common peripheral paralysis of the seventh cranial nerve, characterized by a rapid and unilateral onset. The condition is encountered across different regions and age groups, with its frequency varying by population. AIM OF THE STUDY: This study aimed to identify the detailed demographics and evaluate the duration of illness, associated symptoms, complications, and recurrence rates among 301 children diagnosed with Bell's palsy at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. Additionally, we aimed to examine different treatment modalities and compare prognostic factors. This study sought to address existing knowledge gaps regarding the clinical features and complications of Bell's palsy in pediatric patients. METHODS: In this retrospective study, data were collected from children aged 0-14 years who had been diagnosed with Bell's palsy. All patients meeting the inclusion criteria at KAMC between 1997 and 2023 were included. RESULTS: Facial weakness was observed in 112 (37%) patients, while alterations in the facial/mouth/nasal angle were noted in 206 (68%). Facial numbness was absent in 288 (96%) cases. Regarding complications, 281 (94%) had none, two (0.67%) did not achieve full recovery, one (0.33%) experienced a prolonged disease course, 12 (4%) reported persistent abnormal facial sensations, and two (0.67%) had vision-related issues. Bilateral Bell's palsy occurred in only one patient (0.33%). Prednisolone therapy was administered to 243 (81%) patients, and eye care measures were provided in 216 (72%) cases. CONCLUSION: Bell's palsy in children generally carries a favorable prognosis, with most cases resolving fully without complications. Facial deviation and difficulty closing the eye are common clinical manifestations. Oral corticosteroids represent the most frequently employed treatment, though evidence for their efficacy remains mixed. In our study, approximately 20% of patients experienced recurrence, and some may have multiple episodes. Further research is needed to identify optimal treatment strategies and to clarify prognostic factors.