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Bilateral sequential facial palsy during chickenpox
M van der Flier1, C van Koppenhagen, F J Disch
1Department of Paediatrics, St. Antonius Hospital, Koekoekslaan 1, 3534 CM Nieuwegein, The Netherlands.
Insights
Facial palsy is a rare neurological complication of chickenpox. This case illustrates how varicella-zoster virus can cause facial nerve damage through different pathways during infection.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Chickenpox, a common viral illness, can rarely lead to neurological complications.
- Facial palsy, or paralysis of facial muscles, is an uncommon but recognized complication.
Observation:
- A 5-year-old girl presented with right-sided facial palsy preceding the typical chickenpox rash.
- She later developed left-sided facial palsy after the chickenpox exanthem appeared.
Findings:
- The case demonstrates both hematogenous and neurogenous spread of the varicella-zoster virus as mechanisms for facial palsy.
- The timing of the facial palsy in relation to the infection phases is highlighted.
Implications:
- Understanding these mechanisms is crucial for diagnosing and managing facial palsy in chickenpox patients.
- This case underscores the diverse neurological manifestations of varicella-zoster virus infection.
Unlabelled:
Facial palsy is a rare neurological complication of chickenpox. A 5-year-old girl exhibited a right facial palsy followed by the appearance of the characteristic chicken pox exanthem. Subsequently she suffered a left facial palsy. In this patient both pathophysiological mechanisms responsible and their relation to the phase of infection are illustrated.
Conclusion:
Facial palsy as a complication of chickenpox can result from pre-eruptive haematogenous or neurogenous spread of varicella-zoster virus.