BACKGROUND: Reactivation of herpes simplex virus type 1 is thought to be a major cause of adult idiopathic peripheral facial paralysis or Bell's palsy. However, few studies have examined the pathogenesis of this condition in children. Serologic assays and polymerase chain reaction (PCR) analysis of paired sera and saliva samples were used here to investigate the causes of acute peripheral facial paralysis in pediatric patients. METHODS: A total of 30 children with acute peripheral facial paralysis were recruited. Paired sera were assayed for evidence of herpesvirus, mumps virus or Borrelia infection. PCR was used to detect herpes simplex virus type 1 and varicella-zoster virus (VZV) DNA in saliva samples. RESULTS: Ramsay Hunt syndrome with accompanying zoster lesions was diagnosed clinically in 2 patients, and VZV reactivation was confirmed serologically. VZV reactivation in the absence of zoster (zoster sine herpete) was diagnosed in 9 patients with either serologic assays or PCR. Thus VZV reactivation was demonstrated in 11 of 30 (37%) patients. The prevalence of VZV reactivation among patients between 6 and 15 years of age was significantly higher than in those younger than 5 years of age (53% versus 9%, P = 0.023). CONCLUSIONS: Our data indicate that VZV reactivation is an important cause of acute peripheral facial paralysis in children, especially those between 6 and 15 years of age.
BACKGROUND: Reactivation of herpes simplex virus type 1 is thought to be a major cause of adult idiopathic peripheral facial paralysis or Bell's palsy. However, few studies have examined the pathogenesis of this condition in children. Serologic assays and polymerase chain reaction (PCR) analysis of paired sera and saliva samples were used here to investigate the causes of acute peripheral facial paralysis in pediatric patients. METHODS: A total of 30 children with acute peripheral facial paralysis were recruited. Paired sera were assayed for evidence of herpesvirus, mumps virus or Borrelia infection. PCR was used to detect herpes simplex virus type 1 and varicella-zoster virus (VZV) DNA in saliva samples. RESULTS:Ramsay Hunt syndrome with accompanying zoster lesions was diagnosed clinically in 2 patients, and VZV reactivation was confirmed serologically. VZV reactivation in the absence of zoster (zoster sine herpete) was diagnosed in 9 patients with either serologic assays or PCR. Thus VZV reactivation was demonstrated in 11 of 30 (37%) patients. The prevalence of VZV reactivation among patients between 6 and 15 years of age was significantly higher than in those younger than 5 years of age (53% versus 9%, P = 0.023). CONCLUSIONS: Our data indicate that VZV reactivation is an important cause of acute peripheral facial paralysis in children, especially those between 6 and 15 years of age.
Authors: Peter Norberg; Jan-Ake Liljeqvist; Tomas Bergström; Scott Sammons; D Scott Schmid; Vladimir N Loparev Journal: J Virol Date: 2006-10 Impact factor: 5.103
Authors: Jean Tsai; Randall J Cohrs; Maria A Nagel; Ravi Mahalingam; D Scott Schmid; Alexander Choe; Don Gilden Journal: J Neurol Sci Date: 2011-09-15 Impact factor: 3.181
Authors: Marius Birlea; Randall J Cohrs; Nathan Bos; Satish K Mehta; Duane L Pierson; Don Gilden Journal: J Med Virol Date: 2013-11-06 Impact factor: 2.327
Authors: Michael J Silverberg; Michael F Schneider; Barbara Silver; Kathryn M Anastos; Robert D Burk; Howard Minkoff; Joel Palefsky; Alexandra M Levine; Raphael P Viscidi Journal: Clin Vaccine Immunol Date: 2006-04
Authors: Don Gilden; Maria A Nagel; Ravi Mahalingam; Niklaus H Mueller; Elizabeth A Brazeau; Subbiah Pugazhenthi; Randall J Cohrs Journal: Future Neurol Date: 2009-01-01
Authors: Anne A Gershon; Judith Breuer; Jeffrey I Cohen; Randall J Cohrs; Michael D Gershon; Don Gilden; Charles Grose; Sophie Hambleton; Peter G E Kennedy; Michael N Oxman; Jane F Seward; Koichi Yamanishi Journal: Nat Rev Dis Primers Date: 2015-07-02 Impact factor: 52.329