Bell’s Palsy: A Rare Presentation; Arachnoid Cyst in Posterior Fossa

Abstract

Facial nerve palsy in children has multiple causes, with idiopathic Bell’s palsy being the most frequent and usually self-limiting. Infectious agents such as herpes simplex, EBV, varicella-zoster, CMV, mumps, HIV, and bacterial infections like otitis media, mastoiditis, tuberculosis, and Lyme disease are important considerations. Trauma from birth injury, temporal bone fractures, or surgery can also lead to palsy. Neoplastic causes include acoustic neuroma, leukemia, lymphoma, and parotid tumors. Congenital anomalies and syndromes like Moebius syndrome may present early, while autoimmune or inflammatory conditions such as sarcoidosis and Guillain–Barré syndrome are less common. Though rare, metabolic disorders like diabetes can also contribute. A comprehensive evaluation is essential to rule out secondary causes in children. While most pediatric facial nerve palsies are idiopathic, careful evaluation is crucial to exclude secondary rare causes that may require specific management.