title: Microbiologic findings in acute facial palsy in children.
abstract: OBJECTIVE
  Microbiologic causes of facial palsy in children were investigated.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Forty-six children aged 0 to 16 years with peripheral facial palsy.
  
  
  METHODS
  Paired serum samples and cerebrospinal fluid were tested to find indications of microbes associated with facial palsy. The microbes tested were herpes simplex virus 1 and 2, varicella-zoster virus, human herpesvirus-6, Mycoplasma pneumoniae, Borrelia burgdorferi, influenza A and B virus, picorna, cytomegalovirus, parainfluenza virus, respiratory syncytial virus, coxsackie B5 virus, adenovirus, and enterovirus, Chlamydia psittaci, and Toxoplasma gondii. Besides the routine tests in clinical practice, serum and cerebrospinal fluid samples were tested with a highly sensitive microarray assay for DNA of herpes simplex virus 1 and 2; human herpes virus 6A, 6B, and 7; Epstein-Barr virus, cytomegalovirus, and varicella zoster virus.
  
  
  RESULTS
  Incidence for facial palsy was 8.6/100,000/children/year. Cause was highly plausible in 67% and probable in an additional 11% of cases. Borrelia burgdorferi caused facial palsy in 14 patients (30%), varicella zoster virus in 5 (11%) (one with concomitant adenovirus), influenza A in 3 (6%), herpes simplex virus 1 in 2 (4%) (one with concomitant enterovirus), otitis media in 2 (4%), and human herpesvirus 6 in 2 (4%). Mycoplasma pneumoniae, neurofibromatosis, and neonatal age facial palsy affected 1 child (2%) each.
  
  
  CONCLUSIONS
  Microbiologic etiology association of pediatric facial palsy could frequently be confirmed. Borreliosis was the single most common cause; hence, cerebrospinal fluid sampling is recommended for all pediatric cases in endemic areas. Varicella zoster virus accounted for 11% of the cases, being the second most common factor.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland. mervi.kanerva@gmail.com
authors: Mervi
authors: M
authors: Kanerva
authors: Janne
authors: J
authors: Nissinen
authors: Kirsi
authors: K
authors: Moilanen
authors: Minna
authors: M
authors: Mäki
authors: Pekka
authors: P
authors: Lahdenne
authors: Anne
authors: A
authors: Pitkäranta
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000818:Animals; D000907:Antibodies, Bacterial / Q000032:analysis / Q000134:cerebrospinal fluid; D000914:Antibodies, Viral / Q000032:analysis / Q000134:cerebrospinal fluid; D001424:Bacterial Infections / Q000150:complications / Q000382:microbiology; D020330:Bell Palsy / Q000382:microbiology* / Q000821:virology*; D001898:Borrelia / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D020852:Lyme Neuroborreliosis / Q000145:classification / Q000382:microbiology; D008297:Male; D011446:Prospective Studies; D013987:Ticks; D014777:Virus Diseases / Q000150:complications / Q000821:virology
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral