Varicella-zoster virus reactivation is an important cause of acute peripheral facial paralysis in children.
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.
Furuta
Yasushi
Y
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. yfuruta@med.hokudai.ac.jp
Ohtani
Fumio
F
Aizawa
Hiroshi
H
Fukuda
Satoshi
S
Kawabata
Hiroki
H
Bergström
Tomas
T
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
D000914:Antibodies, Viral