Infant Facial Paralysis Associated with Epstein-Barr Virus Infection

Abstract

Patient: Male, 23 monthsFinal Diagnosis: Peripheral facial paralysis associated with Epstein-Barr virus infectionSymptoms: Facial paralysisMedication: —Clinical Procedure: Microbiology diagnosisSpecialty: Infectious DiseasesObjective:Rare diseaseBackground:Peripheral facial paralysis is a clinical presentation which, in most cases, is benign. It is relatively frequent, although less so in pediatric patients, where clinical diagnosis is more difficult. This clinical condition can be congenital, neurological, infectious, neoplastic, traumatic, or metabolic in origin.Case Report:This report describes the case of a male infant of 23 months of age with peripheral facial paralysis due to Epstein-Barr virus (EBV) upper respiratory infection. A hemogram showed the presence of leukocytosis and lymphocytosis, and a peripheral blood smear indicated the presence of stimulated lymphocytes. Serological tests were compatible with recent EBV infection: IgM anti-VCA (capsid antigen) was positive, while IgG anti-VCA and anti-EBNA (nuclear antigen) were negative. EBV genome was detected in pharyngeal swab and in serum, where viral load was 5.08 log copies/1000 cells and 3.72 log copies/mL, respectively.Conclusions:Whilst the most common cause of facial paralysis is idiopathic paralysis, such problems of the facial nerve may have many origins, including an infectious nature such as infection with viral agents. Rapid determination of the etiology of the problem allows the most appropriate management of the condition and quick follow-up to be implemented, which is essential for the evaluation of treatment response and the avoidance of permanent consequences.

Seltene Erkrankungen der Speicheldrüsen und des Nervus Facialis

“…The primary infection often occurs in children while adults may also observe virus reactivation. Hereby, also the levels of EBNA antibodies are increased [245]. Vogelnik and Matos describe 5 own and 4 reported pediatric cases where the facial nerve palsy was clinically associated with acute otitis media [246].…”

“…Die primäre Infektion tritt häufiger bei Kindern auf, während es bei Erwachsenen auch zu einer Virusreaktivierung kommen kann. Hierbei sind auch EBNA-Antikörper erhöht 245 . Vogelnik und Matos beschreiben 5 eigene und 4 berichtete pädiatrische Fälle, bei denen klinisch die Facialisparese im Zusammenhang mit einer akuten Otitis media stand 246 .…”

An unusual cause of facial nerve palsy affecting a mum and her child with literature review and analysis for other causes

“…The incidence of this syndrome under 10 years of age is reported to be 2.7/100,000. Not frequently, bilateral facial nerve palsy may be caused by Epstein-Barr virus infection, Haemophilus influenza, tuberculosis or Borrelia burgdorferi infection [17]. Other agents that may cause facial nerve palsy in children are cytomegalovirus, adenovirus, rubella, mumps, Mycoplasma pneumonia and HIV [1,4].…”

"Effects of Real-Time iEMG Biofeedback on Facial Muscle Activation Patterns in a Child with Congenital Unilateral Facial Palsy"

“…[7]; Deep, et al [8]; Kim, et al [9]; Kouri, et al [10]; Vogelnik & Matos [11]). For facial palsies with a known cause, one can identify a course of treatment such as surgery, medication, or therapy (Álvarez-Argüelles, et al [12]; Sam, et al [6]), however in others with idiopathic facial paralysis, there is a less direct path to intervention that allows for reanimation of the facial nerve.…”