Effect of Six Week Interdisciplinary Approach in a Toddler with Idiopathic Facial Nerve Palsy- A Case Report

Abstract

Background: Bell's palsy is an idiopathic, abrupt, unilateral facial paralysis of the lower motor neurons. Despite being frequently observed in adults, it is exceptionally rare in infants and toddlers, which presents difficulties for pediatric patients in terms of diagnosis and further interventions.

Case Presentation: A 2.5-year-old boy presented with sudden facial asymmetry, mouth deviation to the unaffected side, and difficulty to close the eye on one side. there was No known history of systemic sickness, infection, or trauma . A clinical examination revealed characteristic features of facial nerve palsy caused by a unilateral lower motor neuron. The diagnosis of idiopathic Bell's palsy was made in light of clinical findings. the administration of oral corticosteriods was admionistered in conjunct to the physiotherapeutic reference.

Intervention: A Multidisciplinary interventions were adopted which included administration of corticosteriod in conjuction with physiotherapy. physiotherapy interventions included  parent education and counselling, eye care and protection strategies, facial massage emphasizing lymphatic drainage, Kabat therapy (proprioceptive neuromuscular facilitation techniques for facial muscles), oromotor exercises, and mirror feedback exercises to enhance voluntary control and symmetry. 

Outcome: Progressive improvement in facial symmetry, eye closure, and voluntary muscle activity was observed post intervention and it was assessed through House Brackmann Facial Paralysis Scale.

Results: The score assessed on House Brackmann scale suggests that there was marked improvement in the toddler post medical and physiotherapy intervention.

Conclusion: Early corticosteroid medication combined with multimodal physiotherapy, involving caregiver engagement and specialist facial rehabilitation approaches, produced positive results. This instance emphasizes the significance of prompt interdisciplinary management in pediatric Bell's palsy.