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A prospective clinical, virological and immunological study was performed on 25 consecutive Bell's palsy (BP) patients. Multiple cranial nerve involvement was found in 15 patients. A significant decrease in the peripheral blood T lymphocyte percentage as well as an increase in B lymphocyte percentage (p less than 0.001) were found in 13 of the BP patients during the first 24 days from the clinical onset of the paralysis. No correlation was found between the peripheral blood lymphocyte subpopulations and the patient's age, sex, degree of paralysis or recovery rate. No changes were detected in the levels of immunoglobulins (IgG, IgM), complement (C3, C4) and antiviral antibodies to herpes simplex and zoster, EBV, cytomegalic virus, adenovirus, influenza and mumps. The clinical and immunological data of BP show a similar pattern to those of Guillain-Barre syndrome suggesting that BP may be an antoimmune demyelinating cranial polyneuritis which may be caused by a preceding viral infection.

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