Clinical characteristics and hematological inflammatory markers in pediatric peripheral facial paralysis: A retrospective study

Aim: This study aimed to determine whether inflammatory indices derived from complete blood count indicate systemic inflammation at presentation in pediatric idiopathic Bell’s palsy. Material and Methods: We retrospectively analyzed 23 children with Bell’s palsy and 69 age- and sex-matched healthy controls (March 2022–June 2025). Peripheral blood was drawn at presentation and before corticosteroid therapy. Indices included neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, lymphocyte/monocyte ratio, eosinophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio, and red cell distribution width/platelet ratio, mean platelet volume, platelet distribution width, plateletcrit were analyzed comparatively. Results: Of the patients, 12 (52.2%) were female and 11 (47.8%) were male, with a mean age of 12.1 ± 3.8 years (range: 2–17). Based on the House–Brackmann classification, 17 (73.9%) patients were grade 2, 5 (21.7%) were grade 3, and 1 (4.4%) was grade 4. No statistically significant differences were found between the patient and control groups in terms of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, lymphocyte/monocyte ratio, eosinophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio, plateletcrit, and red cell distribution width/platelet ratio values (for all variables p > 0.05). Mean platelet volume and platelet distribution width were lower in patients (Cliff’s δ = −0.34 for both; 95% CI −0.58 to −0.10, p = 0.015 for each). House–Brackmann grade correlated with plateletcrit (Spearman’s ρ = 0.58; 95% CI 0.24 to 0.79; p = 0.004).Conclusion: Modest reductions in mean platelet volume and platelet distribution width, along with a positive correlation between plateletcrit and clinical severity, may indicate platelet-axis involvement. Given the limited sample size and statistical power, these findings require confirmation in larger, standardized cohorts.