title: Unilateral facial paralysis occurring in an infant with enteroviral otitis media and aseptic meningitis.
abstract: We report the case of a four month old infant presenting to the Emergency Department (ED) with irritability and facial asymmetry following a recent bout of gastroenteritis. Physical examination revealed a unilateral peripheral facial nerve paralysis. Common in older children and adults, facial nerve palsy has rarely been described in infancy. Although historically associated with a variety of inflammatory and infectious causes, the pathogenesis remains unclear. In this infant we were able to successfully identify an underlying acute enteroviral infection. Coxsackie B5 was isolated from the middle ear fluid, cerebrospinal fluid (CSF), nasopharyngeal and rectal swabs. After myringotomy drainage of the middle ear fluid and placement of pneumatic equalization tubes, there was rapid and complete resolution of facial paralysis.
authors.affiliation: Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hostetler
authors.forename: Rahaman O
authors.initials: RO
authors.lastname: Suara
authors.forename: Mark R
authors.initials: MR
authors.lastname: Denison
mesh_terms: D029822:Enterovirus B, Human / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000150:complications* / Q000628:therapy / Q000821:virology; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008582:Meningitis, Aseptic / Q000150:complications* / Q000628:therapy / Q000821:virology; D010033:Otitis Media / Q000150:complications* / Q000628:therapy / Q000821:virology