Article in Japanese
Role of herpes simplex virus and varicella-zoster virus in pediatric facial nerve paralysis
Kei KOZAWA1), Naoko NISHIMURA1), Shuta KITO1), Kazunori HARUTA1), Tomoyasu NOGUCHI1), Kensei GOTOH1), Koji TAKEMOTO1), Takao OZAKI1)
In order to investigate the role of herpes simplex virus (HSV) and varicella-zoster virus (VZV) in pediatric facial nerve paralysis, twenty-two patients were studied retrospectively. They were aged 8 months to 14 years 9 months and admitted to the Department of Pediatrics at this hospital for a 9-year period from April 2008 through March 2017. Enzyme immunoassay (EIA) antibody titers for HSV and VZV (IgG and IgM, respectively) were assayed in paired sera collected on admission and during the recovery period. PCR was used in 19 patients to detect HSV and VZV DNA in blood. Facial nerve paralysis was judged to be related to HSV or VZV when a positive IgM titer or a significant increase of IgG titer or viral DNA detection occurred.
Among the 22 patients, 3 and 9 had paralysis related to HSV and VZV, respectively. Two patients developed symptoms about 2 weeks after varicella infection. Based on antibody titers, VZV reactivation occurred in 7 patients. Viral DNA was not detected in any of the patients. All 7 patients, who were older than 8 years, had VZV reactivation and 2 of them developed Hunt syndrome. Among the patients with VZV-related paralysis, 2 had received a single dose of varicella vaccine. One patient developed paralysis after varicella infection and another one had VZV reactivation. Facial nerve paralysis improved in all of the patients within 5 weeks of onset.
Facial nerve paralysis was related to either HSV or VZV in 55% (12/22) of pediatric patients. All of the 7 patients older than 8 years had VZV reactivation.
1) Department of Pediatrics, Konan Kosei Hospital
|Key words||facial nerve paralysis, Bell's palsy, Hunt syndrome, herpes simplex virus, varicella-zoster virus|
|Received||December 11, 2017|
|Accepted||July 31, 2018|