Intravenous acyclovir as a treatment for idiopathic peripheral facial palsy in a newborn. Case Report
DOI:
https://doi.org/10.17533/udea.iatreia.111Keywords:
acyclovir, Bell palsy, drug therapy, facial nerve, infant, newbornAbstract
Introduction: Neonatal facial palsy due to Bell’s palsy is rare. A traumatic delivery mechanism represents a common etiology.
Clinical case: Neonate, without previous illnesses, born by spontaneous non-instrumentalized delivery and without any obstetric complications; who presented acute right facial palsy, with normal brain imaging and clinical findings compatible with Bell’s palsy, who had a good response to antiretroviral management and physical therapy.
Discussion: Most infants with Bell’s palsy improve with or without treatment, with no serious sequelae. In pediatric population, evidence on benefits of steroids use, alone or with antiretrovirals, has not been conclusive. There is not a current consensus on the safety of late postnatal steroid use, and they should be reserved for neonates who have no other treatment choice. Acyclovir use at 60/mg/Kg/day it’s safe in neonates.
Conclusions: Neonatal Bell’s palsy may present a favorable response to antiretroviral therapy and an dherent physical rehabilitation program, irrespective of steroids use.
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References
(1) Singhi P, Jain V. Bell’s Palsy in Children. Semin Pediatr Neurol. 2003;10(4):289–97. DOI 10.1016/S1071-9091(03)00077-9.
(2) Psillas G, Antoniades E, Ieridou F, Constantinidis J. Facial nerve palsy in children : A retrospective study of 124 cases. J Paediatr Child Health. 2019;55(3):299–304. DOI 10.1111/jpc.14190.
(3) Saini A, Singhi P, Sodhi KS, Gupta A. Bell palsy in a neonate with rapid response to oral corticosteroids: A case report. J Child Neurol. 2013;28(4):506–8. DOI 10.1177/0883073812444734.
(4) Pandita A, Mishra N, Gupta G, Shukla A. Neonatal facial palsy, a case series: Is CPAP the culprit? BMJ Case Rep. 2018;2018:1–5. DOI 10.1136/bcr-2018-224842.
(5) Khair AM, Ibrahim K. Idiopathic non-traumatic facial nerve palsy (Bell’s Palsy) in neonates; An Atypical Age and Management Dilemma. Oman Med J. 2018;33(1):65–8. DOI 10.5001/omj.2018.12.
(6) Gupta AK, Das RR, Panda SS, Panda M. A neonate with facial asymmetry. BMJ Case Rep. 2013;Jul 29:1–2. DOI 10.1136/bcr-2013-200096.
(7) Reddy S, Redett R. Facial paralysis in children. Facial Plast Surg. 2015;31(2):117–22. DOI 10.1055/s-0035-1549042.
(8) Sánchez N, Hernández M, Cruz JP, Mellado C. Espectro fenotípico de Síndrome de CHARGE neonatal. Rev Chil Pediatr. 2019;90(5):533–8. DOI 10.32641/rchped.v90i5.1080.
(9) Ramírez Cheyne J, Marín Cuero D, Isaza C, Saldarriaga Gil W, Pachajoa Londoño H. Asociación VACTERL y síndrome de Moebius en un recién nacido expuesto prenatalmente a misoprostol. Iatreia. 2014;27(2):216–20.
(10) Decraene L, Boudewyns A, Venstermans C, Ceulemans B. Developmental unilateral facial palsy in a newborn: six cases and literature review. Eur J Pediatr. 2020;179(3):367–75. DOI 10.1136/bcr-2015-211212.
(11) Magalhães M, Costa D, Brites A, Teixeira J. Facial asymmetry in crying newborn. BMJ Case Rep. 2015;Jul 6:1–2.
(12) Rizk EB, El-Bitar MA, Matar GM, Saad KG, Mikati MA. Facial Nerve Palsy with Acute Otitis Media During the First 2 Weeks of Life. J Child Neurol. 2005;20(5):452–4. DOI /10.1177/08830738050200050901.
(13) Obeid M, Price J, Sun L, Scantlebury MH, Overby P, Sidhu R, et al. Facial palsy and idiopathic intracranial hypertension in twins with cystic fibrosis and hypovitaminosis A. Pediatr Neurol. 2011;44(2):150–2. DOI 10.1016/j.pediatrneurol.2010.10.002.
(14) Kouri I, Mathews K, Joshi C. Facial Weakness and Ophthalmoplegia in a 4-Day-Old Infant. Semin Pediatr Neurol. 2018;26:63–6. DOI 10.1016/j.spen.2017.03.008.
(15) Chen W, Wong V. Prognosis of Bell’s palsy in children — analysis of 29 cases. Brain Dev. 2005;27:504–8. DOI 10.1016/j.braindev.2005.01.002.
(16) Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell Palsy and Herpes Simplex Virus: Identification of Viral DNA in Endoneurial Fluid and Muscle. Ann Intern Med. 1996;124(1):27–30. DOI 10.7326/0003-4819-124-1_Part_1-199601010-00005.
(17) Fujiwara T, Matsuda S, Tanaka J, Hato N. Facial paralysis induced by ear inoculation of herpes simplex virus in rat. Auris Nasus Larynx. 2017;44(1):58–64. DOI 10.1016/j.anl.2016.04.002.
(18) Adour KK, M BF, Hilsinger RLJ, Sheldon M. The True Nature of Bell’s Palsy: Analysis af 1,000 Consecutive Patients. Laryngoscope. 1978;88(5):787–801. DOI 10.1002/lary.1978.88.5.787.
(19) Coker NJ. Bell Palsy : A Herpes Simplex Mononeuritis ? Combination Treatment With Acyclovir and Prednisone for Bell Palsy. Arch Otrolaryngol Head Neck Surg. 2015;124(July 1998):823–4. DOI 10.1001/archotol.124.7.823.
(20) Ericson JE, Gostelow M, Autmizguine J, Hornik C, Clark RH, Bejamin Jr. DK, et al. Safety of High-Dose Acyclovir in Infants with Suspected and Confirmed Neonatal Herpes Simplex Virus Infections. Pediatr Infect Dis. 2017;36(4):369–73. DOI 10.1097/INF.0000000000001451.
(21) Pitaro J, Waissbluth S, Daniel SJ. Do children with Bell’s palsy benefit from steroid treatment ? A systematic review. Int J Pediatr Otorhinolaryngol. 2012;76(7):921–6. DOI 10.1016/j.ijporl.2012.02.044.
(22) Gagyor I, VB M, Daly F, Somasundara D, Sullivan M, Gammie F, et al. Antiviral treatment for Bell’s palsy (idiopathic facial paralysis ) (Review). Cochrane Database Syst Rev. 2015;9. DOI 10.1002/14651858.D001869.pub6.
(23) Halliday HL. Update on Postnatal Steroids. Neonatology. 2017;111:415–22. DOI 10.1159/000458460.
(24) Barrington KJ. The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs. BMC Pediatr. 2001;1(1):1–9. DOI 10.1186/1471-2431-1-1.
(25) Doyle L, Ehrenkranz R, Halliday H. Late (> 7 days) postnatal corticosteroids for chronic lung disease in preterm infants (Review). Cochrane Database Syst Rev. 2014;5. DOI 10.1002/14651858.CD001145.pub3.
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