Facial Palsy in Neonate: A Cohort Study on Risk Factors and Recovery Patterns

Introduction Neonatal facial palsy is uncommon. Developmental forms are often bilateral and syndromic, while congenital palsy is usually unilateral and results from birth trauma, compression, iatrogenic injury, or infection. Objectives To describe about the cases of facial palsy in terms of age of onset, etiology, investigations, recovery, and outcome. Methods This prospective cohort study over 4 years included neonates with facial palsy. Clinical details, risk factors, and outcomes were documented. All underwent neuroimaging, hearing tests, and ear and eye exams. Eye patching was done, and lubricants were applied. The babies were followed up for 6 months. Results The total number of observed facial palsy cases was 24 over a period of 4 years. The median birth weight and gestational age were 2,149 g and 34 5/7 weeks, respectively. Approximately 80% of the babies had a history of prior continuous positive airway pressure (CPAP) use. The proportion of recovered cases was significantly more in babies with normal neurological examination ( P = .01) and neuroimaging ( P = .04). Conclusions Congenital neonatal facial palsy may present at any time shortly after birth or a few days later. With declining forceps use, common causes now include positive end-expiratory pressure (PEEP) devices, intrauterine procedures, central nervous system (CNS) or auditory infections, and perinatal asphyxia. Most cases resolve within a few months.