Neonatal idiopathic Bell's palsy is a very rare diagnosis with only a few previously published case reports of infants responding well to oral corticosteroid use. This trial therapy likely comes from adult data where clinical outcomes are improved following steroid use, although the data in childhood cases are equivocal. In this specific population of infants <28 days of age at presentation, the most common causes of Bell's palsy include congenital, birth trauma, and syndromic (likely with no indication for steroid treatment). In those with noncongenital Bell's palsy, infectious and structural causes should first be ruled out. In this article, we present the third known case report of a 16-day-old presenting with acute Bell's palsy with negative infectious workup and normal brain imaging. He was treated with a 7-day course of oral prednisone and had eventual resolution of symptoms.
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