General practitioners’ referral pattern for children with acute facial paralysis

El-Hawrani, Amged; Eng, Chee-Yean; Ahmed, Shahzada; Clarke, JV; Dhiwakar, Muthuswamy

doi:10.1258/0022215054352135

Cited by 14 publications

(8 citation statements)

References 5 publications

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“…Despite a lot of similarities concerning pathogenesis, treatment, and outcome there are also some important differences. Facial nerve palsy appears 2–4 times less frequent in children than in adults [ 33 ]. Additionally, facial nerve palsy appears to be more frequently associated with viral infection and with Borreliosis than in adults [ 34 , 35 ].…”

Section: Childrenmentioning

confidence: 99%

Management of peripheral facial nerve palsy

Finsterer

2008

Eur Arch Otorhinolaryngol

264

229

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Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell’s palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell’s palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell’s palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell’s palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell’s palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae.

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Section: Childrenmentioning

confidence: 99%

Management of peripheral facial nerve palsy

Finsterer

2008

Eur Arch Otorhinolaryngol

264

229

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“…13 Bell's palsy is different from other facial palsies as the cause is metabolic or vascular. 14 In cases associated with idiopathic cause (Bell's palsy), ENT examination is essentially normal and majority of patients show good recovery with treatment with steroids, anti-viral drugs and physiotherapy. In cases of otitis media associated with cholesteatoma where mastoidectomy is done and facial nerve is explored, good recovery is observed in cases associated with perifacial granulation tissue.…”

Section: Discussionmentioning

confidence: 99%

Study of Various Causes of Facial Palsy and Its Management Protocol

S¹,

Sharma²,

M³

et al. 2015

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Facial palsy is generally due to a congenital or acquired cause. It is often associated with severe disfigurement, emotional disturbance and anxiety. The causes for facial palsy vary in different age groups. In neonates and infants, the facial palsy is often associated with birth injuries or developmental anomalies of the ear. 1 In adults and older age group, infective conditions like cholesteatoma, tuberculous otitis media, encephalitis and neoplastic condition like glomus jugular tumour and facial nerve tumours are observed as a cause for facial palsy. Recovery from facial nerve palsy depends on the cause. Reasonably good recovery is seen in Bell's palsy after medical treatment. Similar results are obtained in chronic suppurative otitis media associated with granulation tissue after surgical intervention.

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“…In the UK, there is an incidence of 6.6 per 100 000 people in the 0–14-year age bracket 5. This incidence is likely to be an underestimation, as many mild cases may be seen by a general practitioner and not included in the total incidence 6. El-Hawrani et al 6 found that only 22% of children presenting with acute facial nerve paralysis (FNP) were referred to an otolaryngologist.…”

Section: Introductionmentioning

confidence: 99%

“…This incidence is likely to be an underestimation, as many mild cases may be seen by a general practitioner and not included in the total incidence 6. El-Hawrani et al 6 found that only 22% of children presenting with acute facial nerve paralysis (FNP) were referred to an otolaryngologist. They and others suggested that all children presenting in the community with acute BP should be referred to an otolaryngology unit for further investigations and acute management 4 6–8…”

Section: Introductionmentioning

confidence: 99%