What are the features of facial nerve palsies in children?
Reviewed by Lauren Hepworth

The aim if this study was to report ophthalmic related findings and complications in children with facial palsy. Medical records from a tertiary centre were retrospectively searched for children 16 years and under with a diagnosis of facial palsy, over a nine-year period. The data extracted from records included history, demographics, time since onset, aetiology, ocular symptoms, visual acuity, fundus and media findings, ocular alignment and motility, degree of lagophthalmos, Bell’s phenomenon grading, presence of ectropion, and exposure keratopathy. A total of 112 records were included in the analysis, and 18 were excluded due to incomplete documentation. The mean age of onset was 8.3 years of age and 52% were male. The most common aetiology was idiopathic (57%) with neoplastic aetiology only accounting for five cases. Of those with multiple cranial nerve involvement (15%) the most commonly associated was an abducens palsy. The proportion of children with moderate to severe visual acuity reduction was 21% with the most common cause being corneal scarring. A total of 43 had exposure keratopathy noted. The majority of children received medical treatment (74%), with 10% requiring surgical treatment. The authors highlight several limitations of the study, linked to the retrospective methodology, no formal grading system of facial nerve palsy use, variable follow-up schedules, and missing data especially corneal sensation testing. This study outlines the ocular characteristics and complications of paediatric facial nerve palsies. Further longitudinal research into these conditions is required.

Characteristics of facial palsy in 112 children and risk factors for ocular complications.
Bhate M, Vipin A, Singh S.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;27:141.