Anti-herpes IgG and IgG subclass antibodies in Bell's palsy

To ascertain if there is an association between Bell's palsy and infection by viruses of the herpes group, 78 patients and 59 controls were investigated. The specific antiviral IgG subclass pattern in serum against cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and varicella zoster virus (VZV) was analysed using an enzyme-linked immunosorbent assay (ELISA) combined with monoclonal antibodies directed against the four subclasses of human IgG. Additional ELISA assays of IgG and IgM antibodies were also used. The mean titres of IgG antibodies against HSV-1 were higher in the acute and convalescent stages compared with controls. The frequency of values greater than 0.2 for all subclasses was raised in the patients, but not significantly so. The mean values for the subclasses were alike in patients and controls. The mean titres of IgG antibodies against CMV and VZV were similar throughout the palsy and also in controls. In the patients, the pattern of IgG subclasses was different from the controls, but not statistically so. The patients and controls were not seropositive for IgM against CMV and VZV. Four patients in the acute phase, 4 in the convalescent phase and 3 controls were positive for IgM against HSV-1. While the subclass pattern of IgG antibodies against HSV-1 is not diagnostic of reactivation of the virus, the raised IgG antibodies may suggest reactivation of a disease process and/or a superadded infection.