Steroids in Pediatric Bell Palsy: A Systematic Review

Abstract

Objective: Conduct an updated systematic review on the outcome of Bell Palsy (BP) in children following steroid treatment.Method: Medline, Embase, Cochrane Library, and BIOSIS Previews databases were searched obtaining articles from years 2000 to 2010 without any language restriction. Articles describing children aged 0 to 18 years with BP treated solely with corticosteroids were included. The outcome measure was facial movements based on clinical scales.Results: A total of 2293 papers were initially identified. Following review by 2 authors, 68 papers were analyzed in a hard-copy format. Finally, 6 studies were eligible to be included in the systematic review. Four of the studies exclusively included children with BP where in 2; various etiologies of facial palsy were described. The nontreated groups were smaller than the treated groups. Type of steroid and duration of treatment were inconsistently specified. Outcome measures used include the House-Brackmann scale, Yanagihara grading system, and clinical evaluation. Studies analyzed were retrospective cohorts or case-series and were categorized as level 4 of evidence.Conclusion: There were no controlled trials, and level 4 publications predominate. Therefore, the role of steroid treatment for BP in children is still inconclusive. Further studies are required.