High Prevalence of Varicella-Zoster Virus Reactivation in Herpes Simplex Virus-Seronegative Patients with Acute Peripheral Facial Palsy

• Published in: Clinical infectious diseases 2000-03, Vol.30 (3), p.529-533
• Main Authors: Furuta, Yasushi, Ohtani, Fumio, Kawabata, Hiroki, Fukuda, Satoshi, Bergström, Tomas
• Format: Article
• Language: English
• Subjects: acute peripheral facial palsy; Adolescent; Adult; Age Distribution; Aged; Antibodies; Antibodies, Viral - blood; Antigens; Bell palsy; Bell Palsy - pathology; Bell Palsy - virology; Biological and medical sciences; Child; Child, Preschool; Clinical Articles; Facial paralysis; Facial Paralysis - pathology; Facial Paralysis - virology; Herpes Simplex - complications; Herpes Simplex - virology; Herpes simplex virus; Herpes zoster; Herpes Zoster - complications; Herpes Zoster - virology; Herpesvirus 3, Human - genetics; Herpesvirus 3, Human - physiology; Human herpesvirus 1; Human herpesvirus 2; Human viral diseases; Humans; Infectious diseases; Medical sciences; Middle Aged; Peripheral Nervous System Diseases - pathology; Peripheral Nervous System Diseases - virology; Polymerase Chain Reaction; Prevalence; Simplexvirus; Simplexvirus - immunology; Varicella zoster encephalitis; Varicella-zoster virus; Viral diseases; Viral diseases of the nervous system; Virus Activation
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/313721

Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are considered to be the major causes of acute peripheral facial palsy (APFP). One hundred and forty-two patients with APFP were analyzed by serological assays and polymerase chain reaction analysis. Ramsay Hunt syndrome was diagnosed in 21 patients. Of the remaining 121 patients clinically diagnosed with Bell's palsy, VZV reactivation without zoster (zoster sine herpete) was detected in 35 patients (29%). The prevalence of antibodies to HSV among patients with Bell's palsy was significantly higher than the prevalence among those with VZV reactivation (Ramsay Hunt syndrome or zoster sine herpete). In contrast, a high incidence (88%) of VZV reactivation among HSV-seronegative patients with APFP was observed. Our data indicate that VZV is one of the major etiologic agents of clinically diagnosed Bell's palsy and that VZV reactivation causes APFP in most patients who lack antibodies to HSV.