Bell’s Palsy and Other Causes of Facial Nerve Paralysis

Bell’s Palsy in Children Bell’s Palsy Bell’s Palsy and Other Causes of Facial Nerve Paralysis

Diagnosis of Bell’s palsy is reached only once other causes are excluded. In children, Bell’s palsy is a much less common cause of lower neurone facial nerve paralysis than is the case in adults.

Other causes of facial nerve paralysis may include:

Infection

Infections and facial nerve paralysis
Viral – Ramsay Hunt syndrome [6]	Unilateral facial nerve paralysis with herpetiform vesicular eruption and vestibulocochlear dysfunction Pain often more than in Bell’s palsy The cause in this case is herpes zoster virus infection Mumps and herpes simplex virus are also causes of facial nerve paralysis
Lyme disease	Borrelia burgdorferi (spirochete) Spread by the bite of ixodes genus ticks Most common cause of facial nerve paralysis in children in endemic areas Important cause of bilateral facial nerve paralysis
Bacterial	Otitis media [5,6] Mastoiditis Otitis externa and malignant otitis externa Meningitis [6]

Trauma [5]

VII cranial nerve is the most commonly injured nerve in head trauma:

Typically, temporal fracture with nerve transection
Basal skull fracture [6]

Systemic diseases [5]

Systemic diseases which may cause facial nerve paralysis include:

Sarcoidosis [5]
HIV [5,6]
Polio [6]
Tuberculosis [6]
Multiple sclerosis [6]
Guillain–Barré syndrome [6]
Diabetes [6]

Neoplasm [6]

Typically progressive course over 3 weeks, but sudden onset does not rule out:

Parotid gland tumours [5,6]
Pontine tumours [6]
Acoustic neuroma [6]
Leukaemia

Developmental hypoplasia/aplasia [7]

Learning bite

Bell’s palsy is only one of many potential causes of facial nerve paralysis [2,8].

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