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Malays Fam Physician. 2017 Dec 31;12(3):30-32. eCollection 2017.

Facial nerve palsy in a child: Bell's palsy? Think again!

Author information

1
(Corresponding author) MD UKM Penang General Hospital, Jalan Residensi 10990 Penang, Malaysia e-mail: joeesam@gmail.com.
2
(Neurosurgery) USM Penang General Hospital, Jalan Residensi 10990 Penang, Malaysia.
3
(Neurosurgery) USM Penang General Hospital, Jalan Residensi 10990 Penang, Malaysia e-mail: nasserdr@msn.com.

Abstract

Introduction:

Half of facial paralysis in children is idiopathic at origin. However, dismissing facial paralysis as being idiopathic without a thorough history and meticulous examination could be disastrous as illustrated by this case.

Case report:

We report a case of sphenoid wing meningioma in a 4-year-old girl. She first presented with only facial asymmetry that was noticed by her mother. Examination suggested a left upper motor neuron facial nerve palsy. A sphenoid wing meningioma was found on magnetic resonance imaging (MRI) of her brain. She underwent craniotomy and total tumour excision. Histopathological examination of the tumour showed a grade 1 transitional type meningioma. Meningiomas in children are rare compared to the adult population. Presentations in children may be delayed due to their inability to recognise or communicate abnormalities. Distinguishing between upper and lower motor neuron facial palsy is crucial in decision making for facial paralysis in children.

KEYWORDS:

Child; brain neoplasms; facial paralysis; meningioma

PMID:
29527278
PMCID:
PMC5842422

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