Children with Bell’s palsy recover without medication within six months

According to a new study, most children with a condition that causes temporary weakness or paralysis of facial muscles recover without medication within six months.

The research, led by the Murdoch Children’s Research Institute and published in Neurologyfound that the steroid prednisolone had no significant impact on a child’s recovery from Bell’s palsy.

Professor Franz Babl of Murdoch Children said that although studies have shown that the use of steroids in adults with Bell’s palsy helps improve symptoms by minimizing facial nerve swelling and bone damage temporal, similar research was not available for children.

The randomized controlled trial involved 187 participants, aged six months to 17 years, who presented to the emergency department (ED) with Bell’s palsy. The study was staged in 11 emergency departments in the Pediatric Research in Emergency Departments International Collaborative (PREDICT) research network in Australia and New Zealand. They were recruited within 72 hours of symptom onset and received 10 days of treatment with prednisolone or placebo (no active drug).

The study found that 57% of those who took no medication had their facial function recovered at one month, 85% at three months and 93% at six months. For those who received prednisolone, 49% recovered at one month, 90% at three months, and 99% at six months. No serious side effects were recorded during the trial and the most common side effects were temporary changes in behavior and increased appetite.

Bell’s palsy, which causes half of the face to sag, is the third most common condition causing a sudden change in nerve function in children. In most cases, the exact cause of facial weakness is unknown but may be related to a viral infection.

The lack of evidence on the use of steroids in children with Bell’s palsy in children has led to variable practice in their treatment.”

Professor Franz Babl, Murdoch Children’s

Finding out that early treatment with prednisolone does not speed recovery will help GPs, emergency physicians and pediatricians as they discuss with affected families and make more informed decisions.”


Murdoch Children’s Research Institute

Journal reference:

Babl, FE, et al. (2022) Efficacy of prednisolone for Bell’s palsy in children: a multicenter randomized, double-blind, placebo-controlled trial. Neurology.

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