Mild facial paralysis in babies does not need treatment

Mild facial nerve paralysis caused by the use of forceps during birth generally resolves on its own and does not require treatment, according to a new report.
The report followed a study in which doctors reviewed the medical records of 28 babies with facial nerve palsy caused by forceps use between 1989 and 2005.

In all 28 cases, the palsy was classified as mild to moderate. “Except in one neonate, no treatment was initiated in any of the patients,” the authors write; one child received a 14-day course of oral prednisone, a corticosteroid.
“All 21 neonates with adequate long-term follow-up recovered fully after an average period of 24 days.”
“There is discrepancy in the literature on the investigations and/or treatment options to be undertaken in facial palsy owing to birth trauma,” the authors conclude.
Some authors recommend surgery to explore the nerve, whereas most consider observation to be sufficient in uncomplicated cases.
The current results add to evidence that the recovery rate is high without treatment. “This confirms that corticosteroid treatment or surgery should be withheld in neonates presenting with uncomplicated facial nerve palsy resulting from forceps trauma.”
Archives of Otolaryngology and Head and Neck Surgery 2009;135:634-636