Is prednisolone an effective treatment for Bell’s Palsy in children?

Grant ID: EMSS-312R26-2016

Project Summary

Bell’s palsy or acute idiopathic lower motor neurone facial paralysis is characterised by sudden onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. It is the third most common neurological reason for children to present acutely to hospital.

In adults, there is conclusive evidence from two major recent trials that a short course of prednisolone, a cheap, widely available and safe steroid, can significantly increase the number of Bell’s palsy patients who completely recover. While the medical problems associated with Bell’s palsy are similar, in children there is no good evidence that prednisolone is an effective treatment.

Many neurological conditions progress differently in children and treatment methods sometimes vary. Children may react differently to prednisolone and without paediatric evidence; treatment guidelines for children with Bell’s palsy remain absent or vague, with variable and overall low rates of steroid use in children by physicians.

The lack of evidence and clinical uncertainty in the treatment of Bell’s palsy in children warrants a definitive trial to determine the efficacy of prednisolone as a treatment for this condition in children. The aim of this study is to assess the utility of steroids in Bell’s palsy in children in a large multicentre randomised, placebo-controlled, trial. The trial will take place in at least 10 hospitals within Australia and New Zealand, involving more than 500 children.

Leveraged Funds

- $1,102,562 [NHMRC 2015-20 Project Grant – Managed by Murdoch Children’s Research Institute]



- Xiong, X., Huang, L., Herd, D., Borland, M., Davidson, A., Hearps, S.,Mackay, M.T., Lee, K.L., Dalziel, S.R., Dalziel, K., Cheek, J.A., Babl, F. E., 2023. Cost-effectiveness of Prednisolone to Treat Bell Palsy in Children: An Economic Evaluation Alongside a Randomized Controlled Trial. Neurology. DOI: 10.1212/WNL.0000000000207284

- Babl, F.E., Eapen, N., Herd, D., Borland, M.L., Kochar, A., Zhang, M., Oakley, E., Hopper, S.M., Berkowitz, R.G., Wilson, C.L., Williams, A., Mackay, M.T., Lee, K.J., Hearps, S., and PREDICT (Paediatric Research in Emergency Departments International Collaborative) research network, 2023. Agreement of Clinician-Administered and Modified Parent-Administered House-Brackmann Scales in Children with Bell's Palsy. OTO open, 7(1), e44.

- Babl, F. E., Herd, D., Borland, M., Kochar, A., Lawton, B., Hort, J. et al., 2022. Efficacy of Prednisolone for Bell Palsy in Children: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Neurology.

- Babl, F.E., Mackay, M.T., Borland, M.L., Herd, D.W., Kochar, A., Hort, J., Rao, A., Cheek, J.A., Furyk, J., Barrow, L. and George, S., 2017. Bell’s Palsy in Children (BellPIC): protocol for a multicentre, placebo-controlled randomized trial. BMC pediatrics, 17(1), p.53.

- Babl FE, Gardiner KK, Kochar A, Wilson CL, George SA, Zhang M, Furyk J, Thosar D, Cheek JA, Krieser D, Rao AS, Borland ML, Cheng N, Phillips NT, Sinn KK, Neutze JM, Dalziel SR, 2017. Bell's palsy in children: Current treatment patterns in Australia and New Zealand. A PREDICT study. Journal of paediatrics and child health, 53(4), pp.339-342.

- Babl, F.E., Kochar, A., Osborn, M., Borland, M.L., West, A., Williams, A. and Dalziel, S.R., 2021. Risk of Leukemia in Children With Peripheral Facial Palsy. Annals of Emergency Medicine, 77(2), pp.174-177.


- Gardiner K.K, Dalziel S.R, Babl F.E, Kochar A, Krieser D.M, Zhang M, Furyk J, Neutze J.M, Cheek J.A, Sinn K.K, Phillips N.T, George S.A, Borland M, Rao A.S, Cheng N.G, Wilson C.L, and PREDICT Research Network, Bell’s Palsy In Children: Current Treatment Patterns In Australia And New Zealand, A PREDICT Study, Paediatric Academic Societies (PAS) Annual Meeting 2016, April 30 – May 3, Baltimore, Maryland.

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