Varicella zoster and Borrelia burgdorferi are the main agents associated with facial paresis, especially in children.
BACKGROUND
The etiology of facial paresis (FP) often remains unresolved. Yet, a microbial association is frequently suspected.


OBJECTIVE
To evaluate the infectious etiology of FP by using sensitive tests.


METHODS
We studied the serum and cerebrospinal fluid of 42 patients diagnosed with idiopathic peripheral facial paresis using sensitive serological methods and nucleic acid detection and for reference, 42 patients with other neurological disorders (OND) matched for age, sex, season and geographical area.


RESULTS
Varicella zoster virus and Borrelia burgdorferi accounted for 56% of all associated agents in children with FP compared with 11% of OND (P=0.01). In adults, the respective numbers were 29 and 13%. Other treatable etiological agents, Chlamydia pneumoniae and Mycoplasma pneumoniae, accounted for 11% in children and 8% in adults and with the same prevalence between patients with FP and OND.


CONCLUSIONS
Microbes, with specific therapy available accounted for 52% of all associated agents in the patients with FP when compared with 26% in controls with OND (P=0.04). Based on this, we conclude that the patients with FP may benefit from antimicrobial therapy.
Jäämaa
Sari
S
Departments of Virology, Bacteriology and Immunology, Laboratory Diagnostics, University of Helsinki, Haartman Institute, P.O. Box 21, Haartmaninkatu 3, Helsinki FIN-00014, Finland.
Salonen
Matteus
M
Seppälä
Ilkka
I
Piiparinen
Heli
H
Sarna
Seppo
S
Koskiniemi
Marjaleena
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D025065:Borrelia burgdorferi / Q000276:immunology / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D016993:Chlamydophila pneumoniae / Q000276:immunology / Q000302:isolation & purification; D004279:DNA, Viral / Q000134:cerebrospinal fluid; D005158:Facial Paralysis / Q000097:blood / Q000134:cerebrospinal fluid / Q000382:microbiology*; D005260:Female; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000276:immunology / Q000302:isolation & purification
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D004279:DNA, Viral