Lack of association of Bell Palsy with acute leukemia in children.

Previous publications report an association between Bell Palsy and leukemia, raising concerns about prescribing corticosteroids for children with facial paralysis before considering leukemia diagnosis. The purpose of this study is to further assess the relationship between Bell palsy and leukemia/lymphoma in children. We conducted a retrospective smart data query from the Kapi'olani Medical Center's electronic medical record system searching for the ICD9/ICD10 diagnosis codes for Bell Palsy occurring during encounters in the emergency department, outpatient clinics, and inpatient services in patients under 19 years of age. Of the 547 Bell palsy cases that were identified, three patients with leukemia were found. Only one patient had the correct temporal association in that the patient presented with Bell palsy and was subsequently diagnosed with leukemia 4 years later, resulting in a rate of 0.18% (95%CI 0% to 0.54%, which is not significantly different from zero). Our data cannot confirm an association between Bell palsy and acute leukemia/lymphoma in children. However, it might be prudent to obtain a CBC for Bell Palsy patients prior to initiating corticosteroid treatment as part of shared decision making.