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

ABSTRACT

Introduction: Half of facial paralysis in children is idiopathic at origin. However, dismissing facialparalysis as being idiopathic without a thorough history and meticulous examination could bedisastrous as illustrated by this case.Case report We report a case of sphenoid wing meningioma in a 4-year-old girl. She firstpresented with only facial asymmetry that was noticed by her mother. Examination suggested aleft upper motor neuron facial nerve palsy. A sphenoid wing meningioma was found on magneticresonance 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 childrenmay be delayed due to their inability to recognise or communicate abnormalities. Distinguishingbetween upper and lower motor neuron facial palsy is crucial in decision making for facial paralysisin children.