title: Varicella-zoster virus reactivation is an important cause of acute peripheral facial paralysis in children.
abstract: 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.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. yfuruta@med.hokudai.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Furuta
authors.forename: Fumio
authors.initials: F
authors.lastname: Ohtani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aizawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukuda
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawabata
authors.forename: Tomas
authors.initials: T
authors.lastname: Bergström
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood; D020330:Bell Palsy; D002648:Child; D002675:Child, Preschool; D005158:Facial Paralysis / Q000821:virology*; D016697:Herpes Zoster Oticus / Q000175:diagnosis; D014645:Herpesvirus 3, Human / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D014775:Virus Activation; D031368:Zoster Sine Herpete / Q000175:diagnosis
chemical_list: D000914:Antibodies, Viral