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Facial Paralysis

Leo Leonidas MD, FAAP

WARNING, WARNING, WARNING; This section is for my Tufts University medical students. If you are a "worrier" type or a very anxious parent, please talk to your clinician about your child's problem or symptoms, rather than reading this differential diagnosis.

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CAUSES OF FACIAL PARALYSIS

The most common cause of facial paralysis in children is Bell's Palsy.
This is followed by Trauma, Ear Infection, Congenital Causes, and
Kawasaki disease, and Lyme Arthritis. Others are rara avis.

INFECTIOUS CAUSES

Ear Infection (Otitis Media)
Lyme Arthritis
Mastoiditis (Bone Infection Behind the Ear)
Osteomylitis Of Temporal Bone
Brain Abscess
Herpes Zoster Oticus (Ramsay Hunt Syndrome)
Meningitis
Encephalitis
Guillain-Barre Syndrome
Infectious Mononucleosis
Influenza
Tuberculosis
Trichinosis
Syphilis

TUMORS & CANCERS

Acoustic Neuroma
Leukemia
Gliomas of Brain Stem
Metastatic Tumors (from Neuroblastoma)
Eosinophilic Granuloma
Tertoma
Hemangioma
Rhabdomyosarcoma
Neurofibromatosis
Parotid Gland Tumors
Facial Nerve Tumors

METABOLIC CAUSES

Hypothyroidism
Osteopetrosis
Diabetes
Uremia

IDIOPATHIC CAUSES

Bells Palsy
Melkrsson Syndrome

CONGENITAL CAUSES
Congenital Facial Paralysis (Mobius Syndrome)
Temporal Bone Malformation
Supranuclear Facial Nerve Lesion
Hypoplasia of the Depressor Anguli Oris Muscle

TRUMATIC CAUSES

Birth Trauma
Facial Injury
Skull Fracture

OTHER CAUSES

Kawasaki Disease
Hydrocephalus
Hypertension
Henoch-Schonlein Purpura
Vascular Lesion
Polyarteritis Nodosa
Postictal Paralysis
Myotonic Dystrophy
DPT Immunization
Drug Reaction (Vincristine is best known)
Freeman Sheldon Syndrome
Schwartz Syndrome
Goldenhar Syndrome
Sarcoidosis

Reference:
Signs & Symptoms in Pediatrics
2nd Edition, page 149
Tunnessen, Jr

Belly Pain   Air Leaks From Lungs   Acute Crying   Back Pain   Bed Wetting   Big Lymph Node   Big Spleen   Blood in Urine Chronic Diarrhea   Chest Pain   Cough   Coughing Up Blood   Constipation Droopy Eye   Enlarged Glands   Eye Swelling   Excessive Thrist   Facial Paralysis   Fainting Spell   Feeding Problem GI Bleeding   Headache   Head Tilt   Hives   High ESR   Hoarseness   Joint Pain   Limp   Leg Pain   Muscle Weakness   Noisy Breathing   Nose Bleeding   Nose Obstruction   Pyuria   Recurrent Infection   Red Green Urine   Ringing in the Ears Scrotal Swelling     Seizures   Stiff Neck   Swelling of the Parotic Gland   Toe Walking   Toeing In   Toeing Out   Unequal Pupils   Vomiting   Wheezing
 

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