Serology in facial paralysis caused by clinically presumed herpes zoster infection.

In some cases of peripheral facial palsy due to a clinically suspected varicella zoster virus (VZV) infection, the clinical diagnosis is not supported by serological tests. In a retrospective study, we examined the sera from 63 patients with clinical findings compatible with VZV infection: 57 had paired sera and 6 had single sera. In the paired-sera group, 18 cases were serologically negative initially by complement fixation (CF), while 9 of these cases were actually positive for VZV when CF was combined with ELISA. Moreover, evidence for a recent mumps virus infection was found in 6 patients and 1 patient was diagnosed as having recent mumps and cytomegalo-virus (CMV) infections. In the 6 single sera studied, the ELISA was suggestive of a recent infection with VZV (4 cases) and CMV (1 case).