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. 2025 Nov 3.
doi: 10.1097/PEC.0000000000003506. Online ahead of print.

Selective Use of Magnetic Resonance Imaging for Facial Palsy in the Pediatric Emergency Department

Da Hyun Kim  1 , Min Kyo Chun  1 , Soo-Young Lim  1 , Seung Jun Choi  1 , Jeong-Yong Lee  1 , Jeeho Han  1 , Jong Seung Lee  2 , Jun Sung Park  1
Affiliations

Selective Use of Magnetic Resonance Imaging for Facial Palsy in the Pediatric Emergency Department

Da Hyun Kim et al. Pediatr Emerg Care. .

Abstract

Objectives: This retrospective observational study evaluated the diagnostic efficiency of routine magnetic resonance imaging (MRI) in pediatric patients with facial palsy (FP) in the emergency department (ED).

Methods: Pediatric patients under 18 years of age who presented with FP at the ED of a single tertiary referral hospital between January 2010 and December 2022 were included. Clinical features were assessed and used for risk stratification, which informed the diagnostic utility of the MRI.

Results: A total of 134 pediatric patients were included [mean age, 99 mo; 53.7% male (n = 72)]. Seventeen patients (12.7%) were diagnosed with central FP (CFP). Among the clinical features, additional neurological examination abnormalities emerged as the most significant risk factor for CFP (odds ratio, 86.3; P < 0.001). Risk stratification based on neurological abnormalities, underlying conditions, and associated symptoms revealed that the diagnostic utility of MRI was significantly higher in the risk group than in the no-risk group (P < 0.001; sensitivity, 100%; specificity, 84.6%). In contrast, patients in the no-risk group who underwent MRI experienced a mean increase of 294 minutes in the ED length of stay compared with those who did not undergo imaging.

Conclusions: Routine MRI is valuable for detecting CFP in pediatric patients with neurological signs. However, its use in low-risk cases may provide limited clinical benefit, prolonging ED stay and increasing unnecessary use of medical resources. Therefore, selective imaging based on clinical indicators is recommended.

Keywords: facial palsy; magnetic resonance image; pediatric emergency.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Jenke AC, Stoek L-M, Zilbauer M, et al. Facial palsy: etiology, outcome and management in children. Eur J Paediatr Neurol. 2011;15:209–213.
    1. Morris AM, Deeks SL, Hill MD, et al. Annualized incidence and spectrum of illness from an outbreak investigation of Bell’s palsy. Neuroepidemiology. 2002;21:255–261.
    1. Rowhani-Rahbar A, Baxter R, Rasgon B, et al. Epidemiologic and clinical features of Bell’s palsy among children in Northern California. Neuroepidemiology. 2012;38:252–258.
    1. Wang CH, Chang YC, Shih HM, et al. Facial palsy in children: emergency department management and outcome. Pediatr Emerg Care. 2010;26:121–125.
    1. Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell’s palsy. Otolaryngol Head Neck Surg. 2013;149:S1–S27.

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