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Abstract: A 3-year-old child was found to have right-sided facial pain with salivation at the corners of the mouth for 4 days and presented with right-sided facial pain with salivation at the corners of the mouth without a cause, and was diagnosed with pediatric drooling syndrome and right-sided facial nerve palsy after examination. After giving anti-inflammatory, nerve-nourishing and circulation-improving medication and acupuncture, the child’s facial palsy symptoms were reduced, salivation and orofacial distortion improved significantly, and facial pain disappeared.
Basic information】Male, 3 years old
Disease Type】Pediatric salivation and right facial nerve palsy
Hospital】The First Affiliated Hospital of Zhengzhou University
Time of consultation】October 2018
Treatment plan】Medication (prednisone acetate tablets, rat nerve growth factor for injection, vitamin B1 tablets, vitamin B6 tablets, methylcobalamin tablets, salvia polyphenolate for injection) + acupuncture rehabilitation physiotherapy
Treatment period】Inpatient treatment for 6 days, continued medication at home until 2 weeks, outpatient follow-up after 1 month
Treatment effect]: Facial palsy symptoms were reduced, salivation and mouth tilting were significantly improved, and facial pain disappeared.
I. Initial face-to-face examination
The child was 3 years old and found to have right-sided facial pain with salivation at the corners of the mouth for 4 days, and had no cause for right-sided facial pain with salivation at the corners of the mouth. The right frontal stripe disappeared, the right eyelid was incompletely closed, the right nasolabial fold became shallow, the left angle of the mouth of the teeth was deviated, the right side of the cheek was leaking, and the corners of the mouth were salivating. There was no herpes in the oral cavity, and the gag reflex was present. Preliminary diagnosis: pediatric salivation and right facial nerve palsy.
Treatment history
The child was admitted to the hospital with clear signs of right-sided peripheral facial palsy, and facial nerve palsy was considered to cause facial muscle weakness, resulting in salivation at the corners of the mouth. Prednisone acetate tablets were given to reduce facial nerve edema, while injectable rat nerve growth factor, vitamin B1 tablets, vitamin B6 tablets, and methylcobalamin tablets were given to nerve nutrition therapy, and injectable salvia polyphenolic acid salt was given to improve circulation.
III. Treatment effect
After hormone anti-inflammation, circulation improvement, nerve nutrition treatment and acupuncture rehabilitation physiotherapy, the child’s facial palsy symptoms were reduced, the salivation at the right corner of the mouth improved, the right eye could be closed, the crookedness of the corner of the mouth to the left side improved significantly, and the right facial pain disappeared. Physical examination: no tenderness on the right side of the face, slightly shallow frontal lines on the right side, normal eyes closed bilaterally, slightly leftward angle of the mouth, slightly air leakage on the right side of the cheek puff, most of the symptoms were better than at the time of admission, so he was discharged after 6 days of hospitalization, and was instructed to follow up on an outpatient basis after 1 month.
Notes
We are glad that the child’s symptoms have improved after treatment, but since the child has not been completely cured for a short period of time, he needs to continue to use nerve-nourishing drugs and hormones, and stop using them for 2 weeks for observation. Acupuncture and physiotherapy can be continued locally to promote recovery. Observe the changes in facial nerve palsy signs, and return to the hospital for follow-up if the condition recurs or worsens. Recovery from facial nerve palsy varies. If recovery is slow, active treatment should be given within 3 months to reduce the risk of sequelae. Pay attention to a reasonable diet, prevent infection, and avoid washing the face with cold water.
V. Personal insight
The etiology of pediatric salivation is complex, and most of them are physiological salivation, which can be terminated by itself with age. Some of them are pathological salivation, such as stomatitis, herpes pharyngitis, facial nerve palsy, cerebral palsy, encephalitis, poisoning, congenital malformation, etc. The child in this case belongs to the pathological salivation caused by typical facial nerve palsy. Therefore, when a child develops salivation, we should take a careful medical history, conduct a detailed examination, clarify the cause and treat the primary disease in order to solve the root of the problem and improve the child’s symptoms.