title: Facial nerve palsy, Kawasaki disease, and coronary artery aneurysm.
abstract: Kawasaki disease is rarely complicated by cranial nerve VII palsy. This report describes a 15-month-old female presenting with 3 days of fever, irritability, and rash who was subsequently diagnosed with Kawasaki disease and treated with intravenous immunoglobulin. She was found to have mild coronary artery ectasia and developed an acute, transient, left-sided facial palsy on the sixth day of illness. Repeat echocardiography demonstrated worsening aneurysm and intravenous methylprednisolone was added to her treatment regimen. At 1 and 3 months post-discharge, echocardiography demonstrated resolution of her coronary aneurysm. This case makes 41 total described in the literature. Patients tend to be under 12-months-old and there is a higher association with coronary artery aneurysm in such patients compared to those without facial palsy who never even received treatment. Kawasaki disease associated with facial palsy may indicate increased inflammatory burden and patients may require additional anti-inflammatory agents and more vigilant echocardiography.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. Electronic address: robert.stowe@bcm.edu.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Stowe
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003323:Coronary Aneurysm / Q000209:etiology*; D004452:Echocardiography; D005155:Facial Nerve Diseases / Q000209:etiology*; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008775:Methylprednisolone / Q000627:therapeutic use; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*
chemical_list: D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D008775:Methylprednisolone
keywords: Bell's palsy; Coronary artery aneurysm; Facial palsy; IVIG; Kawasaki disease