Viral infection as a cause of acute peripheral facial palsy

Among 51 patients with acute peripheral facial palsy, varicella-zoster virus was isolated from the cerebrospinal fluid (CSF) in one case, and Herpesvirus hominis from the nasopharynx in two cases. In 12 other cases, complement-fixing antibody or hemagglutination inhibition tests indicated a recent viral infection (varicella-zoster, seven; herpes simplex, one; cytomegalovirus, one; influenza type B virus, two; and mumps virus, one). One additional patient had clinical signs of herpes zoster oticus. About one third of these 16 virus-positive patients, but also one third of the remaining group, had increased levels of alpha 1-antitrypsin, orosomucoid, haptoglobin, and immunoglobulins. Evidently, an inflammatory reaction preceded or coincided with the facial palsy in both groups. In CSF, an increase of total proteins and gamma-globulins was frequently found among all 20 patients examined (eight were virus-positive).