A Clinical Study on Children and Adolescents Who Visited the Hospital of Korean Medicine for 284-Peripheral Facial Palsy

한방병원에 내원한 소아청소년기 말초성 안면마비 환자 284례를 통한 임상적 고찰

  • Kang, Ki Yeon (Department of Pediatrics, College of Korean Medicine, Daejeon University) ;
  • Lee, Hye Lim (Department of Pediatrics, College of Korean Medicine, Daejeon University) ;
  • Han, Jae Kyung (Department of Pediatrics, College of Korean Medicine, Daejeon University) ;
  • Kim, Yun Hee (Department of Pediatrics, College of Korean Medicine, Daejeon University)
  • 강기연 (대전대학교 한의과대학 소아과학교실) ;
  • 이혜림 (대전대학교 한의과대학 소아과학교실) ;
  • 한재경 (대전대학교 한의과대학 소아과학교실) ;
  • 김윤희 (대전대학교 한의과대학 소아과학교실)
  • Received : 2014.10.31
  • Accepted : 2014.11.17
  • Published : 2014.11.30


Objectives The purpose of this study is to investigate the clinical characteristics in children and adolescents with peripheral facial palsy that was treated with Korean medicine. Methods The study was conducted based on 284 cases that consisted of 261 children (less than 19 years old) who visited the hospital of Korean medicine from August 2010 to August 2014. Then, this study was analyzed by reviewing the patients' charts. Results The incidence of facial palsy in pediatric patients was more common in boys than in girls and the mean age was 11.2 years. The prevalence of facial palsy was more common in winter and most were diagnosed with Bell's palsy. Recurrence was identified in 12.6% of the patients. The average age of the first attack was 9.5 years. It took about 3.2 years for recurrence to occur from the first onset. It took about 5 days to visit the hospital of Korean medicine from the onset. 81% of the patients came within 1 week from the onset. 50.7% of the cases did not receive any treatment before and 49.3% were previously treated at other hospitals. More than half of the patients (65.1%) received Korean medicine first. 54.6% of the patients were hospitalized and 45.4% received outpatient treatments in the hospital of Korean medicine. Outpatient treatments were administered about 11.5 times while hospitalized patients were treated for an average of 16.6 days. In general, hospitalized patients were treated more often than the outpatient group. An overall average duration of treatment was 70.6 days from the onset of facial palsy until the last day of treatment, and 53.0 days from the first day of treatment until the last day of treatment. 41.5% of the cases were treated only with Korean medicine and 49.0% were treated with a combination of Korean and Western medicine. The types of Korean medicine treatment used for facial palsy in descending order of frequency were acupuncture, Infra red, herbal medicine, SSP therapy, electro-acupuncture, carbone, hot pack, cupping, and moxibustion. The treatments that were most frequently used from Western medicines were steroid as monotherapy (61.7%) and a combination of steroids and antiviral therapy (37.6%). Conclusions This result showed that the risk of facial palsy recurrence among children is relatively high and that facial palsy requires a long-term treatment. It's helpful to explain about prognosis, treatment duration, and recurrence potential in children. Facial palsy in children is treated in various ways but more studies about the therapeutic effects of Korean medicine, Western medicine, and combination of Korean-Western medicine in children are needed.


  1. Bell's palsy patients increased annually. News Aritcle by Park SR. Accessed online 17:01:09 September 12, 2014. at Available from :
  2. Baugh RF, Basura GJ, Ishii LE, Schwartx SR, Drumheller CM, Burkholder R, Deckard NA, Dawson C, Driscoll C, Gillespie MB, Gurgel RK. Halperin J, Khalid AN, Kumar KA, Micco A, Munsell D, Rosenbaum S, Vaughan W. Clinical practice guideline : Bell's Palsy. Otolaryngol Head Neck Surg. 2013;149(3S):suppl 1-27.
  3. Jang IS. Is it appropriate to exclude cold exposure from the risk factors of Bell's palsy?. Korean J Acupunct. 2006;23(3):51-4.
  4. Choi MH, Kim DG, Lee JY. A study of the chief compalint of pediatric outpatients in the Kyung Hee oriental medicine hospital. J Pediatr Korean Med. 2010;24(3):121-37.
  5. Kim TI, Suh SI, Lee DK. The effect of acyclovir in acute stage of bell's palsy. J of the K.S.C.N. 2001;3(2):122-7.
  6. Sin MS, Park CK, Choi SW, Yook TH. Clinical studies on herbal acupuncture therapy in peripheral facial palsy. J Pharmacopuncture. 2001;4(2):27-33.
  7. Hwang JH, Lee DG, Lee HJ, Cho HS, Kim KH, Kam KS. Effect of combined silver spike point therapy and electroacupuncture on patients with peripheral faical paralysis. J Korean Acupunct Moxibustion Soc. 2007;24(4):69-80.
  8. Lee JH, Yu SA, Lee SY. Five case reports on peripheral facial palsy in children. J Peditr Korean Med. 2013;27(3):20-8.
  9. Lee DH, Lee JW, Kim DG, Jeong GM. Clinical studies on 18 cases of childhood facial hemiparalysis. J Peditr Korean Med. 1991;5(1):35-42.
  10. Seo WH, Moon IR, Park JT, Kim JY. The clinical study of bell's palsy of children. J Korean Acupunct Moxibustion Soc. 2002;19(5)73-91.
  11. Won YJ, Moon KH, Lee WS, Keum SW, Yu ST, Oh KW, Lee CW. Incidence, clinical features and prognosis of bell's palsy in children. Korean J Pediatr. 2007;50(3):272-6.
  12. Hong CK, Byun JY, Yeo SG, Cha CI, Park MS. Clinical analysis of facial palsy in children. Korean J Otolaryngol. 2007;50:102-7.
  13. Finstere J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngol. 2008;265(7):743-52.
  14. Lee JW, Kwon SA, Kim MJ, Song JY, Kim PK, Seo BK, Woo HS, Park DS, Baek YH. A study of facial palsy sequelae and evaluating scale. J Korean Acupunct Moxibustion Soc. 2011;28(2):75-87.
  15. Khan A, Hussain N, Gosalakkal J. Bells palsy in children-A review. J Pediatr Sci. 2011;3(2):2-11.
  16. Adour KK, Ruboyanes JM, Von Doersten GP, Byl FM, Trent CS, Quesenberry CP Jr, Hitchcock T. Bell's palsy treatment acyclovir and prednisone compared with prednisone alone. a double-blind, randomized, controlled trial. Ann Otol Rhinol Laryngol. 1996;105:371-8.
  17. Kenneth W. Lindsay, Ian B. Neurology and Neurosurgery Illustrated, 4/e. Seoul: EPublic. 2011:227-8.
  18. Pratibha Singhi, Vivek Jain. Bell's palsy in children. Semin Pediatr Neurol. 2003;10(4):289-97.
  19. Unsal Yilmaz, Duygu Cubukcu, Tuba Sevim Yilmaz, Gulcin Akinci, Muazzez Ozcan and Orkide Guzel. Peripheral facial palsy in children. J Child Neurol. 2013;Oct:1-6.
  20. Koh DJ, You HJ, Cho HJ, Kim DG, Lee JY. A case of ramsay hunt syndrome with poor prognosis on EMG. J Pediatr Korean Med. 2004;18(2):127-42.
  21. Lee WS, Kim J. Facial nerve paralysis and surgical management. J Korean Med Assoc. 2009;52(8):807-18.
  22. Korean Society of Otorhinolaryngology. Head and neck surgery I. Seoul: Ilchogak Co. 2009;963-9.
  23. Thomas JG. Pediatric bell palsy: The time is ripe for a clinical trial. J child nerol. 2013;Dec:1.
  24. Lee JD, Cho YS, Jang KH, Lee HK, Kwon KH. Acute inflammatory faical nerve paralysis. Korean J Otorhinolaryngol Head Neck Surg. 2011;54(6):386-91.
  25. Hong KE. Prevalence and treatment pattern of korean patients with facial palsy. J Korean Acupunct Moxibustion Soc. 2010;27(3):137-46.
  26. Kim NK. The clinical observation of facial palsy sequela. J Korean Oriental Med. 2002;23(10):100-11.
  27. Shin YJ, Kwon NH, Park HA, Woo HS, Beak YH, Park DS, Koh HK. Clinical study on recurrent peripheral facial nerve palsy. J Korean Acupunct Moxibustion Soc. 2009;26(1):2-37.
  28. Kim JS, Kim JH, Kim YS, Koh HK, Kang SK, Kim CH. Cross-sectional study on recurrence of bell's palsy. J Korean Acupunct Moxibustion Soc. 2000;17(3):69-74.
  29. Kim NO, Chae SJ, Son SS. A case report of 4th ipsilateral recurrent bell's palsy. J Orient Med Surgery Ophtalmol Otolaryngol. 2001;14(2):198-206.
  30. Van Amstel AD, Devrise PP. Clinical experiences with recurrences of Bell's palsy. Arch Otorhnolaryngol. 1988;245:302-6.
  31. Kim CH, Lee DK. Clinical annalysis of recurrent bell's palsy in one university hospital. Korean Soc Clin Neurophysiol. 2013;15(1):1-6.
  32. Kim KJ, Seok JI, Lee DK. The clinical analysis of recurrent bell's palsy. Korean Soc Clin Neurophysiol. 2007;10(1):38-42.
  33. Wg Cdr H. Swami, Wg Cdr A. Dutta, S. Namiar. Recurrent bell's palsy. MJAFI. 2010;66:95-6.
  34. The Korean Otologic Society. The clinical practice guideline of acute faical nerve palsy. 2011.
  35. Cho KH, Jun WS, Hong JW, Hwang JW, Na BJ, Park SU, Moon SK, Park JM, Ko CN, Kim YS, Bae HS. The effectiveness of orental medical therapy compared to oriental-western medical therapy on acute bell's palsy. J Korean Orient Med. 2008;29(1):146-55.
  36. Won JS, Chou CY, Cho AR, Kim CH. The clinical observation of bell's palsy sequela. J Korean Orient Med Ophthalmol Otolaryngol Dermatol. 2009;22(3):167-77.
  37. Hong JM, Shin KM, Seo GM, Choi SY, Bae KR, Park JY, Baek YH, Nam DW, Lee YH. Clinical comparison study on bell's palsy patients by the period of disease. J Korean Acupunct Moxibustion Soc. 2009;26(2):71-7.
  38. Kang NR, Tark MR, Byun SM, Ko WS, Yoon HJ. A clinical analysis on 250 cases of inpatients with facial paralysis. J Korean Orient Med Ophthalmol Otolaryngol Dermatol. 2010;23(3):109-21.
  39. Won JS, Chou CY, Cho AR, Kim JH, Kim CH. The clinical observation of acute bell's palsy 80 case. J Korean Orient Med Ophthalmol Otolaryngol Dermatol. 2010;23(3):151-62.
  40. Park IB, Kim SW, Lee CW, Kim HG, Heo SW, Youn HM, Jang KJ, Ahn CB. Comparative clinical study between oriental medicine and oriental-western medicine treatment on bell's palsy. J Korean Acupunct Moxibustion Soc. 2004;21(5):191-203.
  41. Marson AG, Salinas R. Clinical evidence : Bell's palsy. Western J Med. 2000;173;266-8.
  42. Michael S, Daune L, Macgregor. Should children with bell's palsy be treated with corticostreriods? A systematic review. J Child Neurol. 2001;16(8):565-8.
  43. Jacob P, Sofia W, Sam JD. Do children with bell's palsy benefit from steroid treatment? A systematic review. Int J Pediatr Otorhinolaryngol. 2012;76 (7):921-6.
  44. Emin Unuvar, Fatma Oguz, Mujgan Sidal, Ayse Kilic.Corticosteroid treatment of childhood bell's palsy. Pediatr Neurol. 1999;21:814-6.
  45. Yasemin Ozkale, Ilknur Erol, Semra Saygi, Ismail Yilmaz. Overview of Pediatric Peripheral Facial Nerve Paralysis: Analysis of 40 Patients. J Child Neurol published online. 2014;May:1-7.
  46. Kumar S, Garg S, Mittal A, Sahni JK. Bell's palsy in early childhood : A series of six casese. Indian J Otol. 2012;18(3):140-2.
  47. Ahn CB, Yoon HM, Jang KJ, Kim CH, Jung KK, Min YK, Kim SM, Kim JE, Cho BG. An analysis of clinical prognosis factors of peripheral facial palsy and the effect of electrodiagnostic test. J Korean Acupunct Moxibusition Med Soc. 2007;24(4):209-21.
  48. Meyer BU. Britton TC, Benecke R. Investigation of unilateral facial weakness. magnetic stimulation of the proximal facial nerve and of the face-associated motor cortex. J Neurol. 1989;236:102-7.
  49. Li Y. Liang FR, Yu SG, Li CD, Hu LX, Zhou D, Yuan XL, Li Y, Xia XH. Efficacy of acupuncture and moxibustion in treating bell's palsy : A multicenter randomized controlled trial in China. Chin Med J (Engl). 2004;117(10):1502-6.
  50. Lee M, Mackay M, Blackbourn L, Babl FE. Emotional impact of bell's palsy in children. J Paediatr Child Health. 2014;50(3):245-7.