Microbiologic Findings in Acute Facial Palsy in Children

Kanerva, Mari; Nissinen, Janne; Moilanen, Kirsi; Mäki, Minna; Lahdenne, Pekka; Pitkäranta, Anne

doi:10.1097/mao.0b013e318289844c

Cited by 25 publications

(30 citation statements)

References 21 publications

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“…Furthermore, some of the patients might have been infected by neurotropic agents not tested for in our present study, i.e. Epstein-Barr virus (EBV), human herpes virus (HHV) 6 or 7, cytomegal virus (CMV), mycoplasma or influenza A or B [18]. Different refined method for detection of different causative agents in the central nervous system (CNS) has been in focus by Huttunen et al [35].…”

Section: Discussionmentioning

confidence: 95%

“…Acute facial nerve palsy or subacute meningitis are major neurological manifestations in LNB [12] [13]. However, facial nerve palsy may also be associated with viral infection, such as an acute or reactivated herpes simplex virus (HSV) infection or a reactivated varicella zoster virus (VZV), even when detectable vesicles or other clinical manifestations of viral infection are absent [14]- [18]. Antiviral therapy and/or corticosteroids have been shown to improve the prognosis in adult patients with idiopathic facial nerve palsy [19], but studies in children are few and not conclusive [20] [21].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Are There Undiagnosed TBE-, Herpes- or Enteroviral Infections among Children Being Evaluated for Lyme Neuroborreliosis?

Skogman¹,

Forsberg²,

Vene³

et al. 2014

OJCD

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Lyme neuroborreliosis (LNB) in children is a challenging diagnosis based on clinical manifestations and laboratory findings. The aim of this study was to investigate whether herpes simplex virus (HSV) 1 or 2, varicella zoster virus (VZV), enterovirus or tick-borne encephalitis virus (TBEV) could be identified in cerebrospinal fluid (CSF) or serum from children being evaluated for LNB, in order to elucidate whether such infectious diseases may be missed by the clinician. Methods: Ninety-nine pediatric patients (n = 99) were retrospectively included from a previous study on LNB in southeast of Sweden. They had been diagnosed as "Possible LNB" or "Not determined" due to negative Borrelia antibody index in CSF. Routine polymerase chain reaction (PCR) methods were used for detection of herpes viral RNA or enteroviral DNA in CSF. An ELISA assay was used for detection of anti-TBEV antibodies (IgM and IgG) in serum. Results: One patient showed elevated anti-TBEV IgM and IgG antibodies in serum, indicating a current TBE infection. No positive PCR reactions for HSV 1 or 2, VZV or enterovirus were detected in CSF from any of the patients. In conclusion, our results suggest that undiagnosed herpes-or enteroviral infections are unlikely to explain CNS symptoms in children being evaluated for LNB, whereas missed TBE infections may occur. TBEV serology should be included when evaluating children for LNB in TBE endemic areas.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Are There Undiagnosed TBE-, Herpes- or Enteroviral Infections among Children Being Evaluated for Lyme Neuroborreliosis?

Skogman¹,

Forsberg²,

Vene³

et al. 2014

OJCD

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“…[2][3][4][5][6] In children, infectious causes of PFP may be varied such as herpes simplex virus 1 and 2, varicella-zoster virus, human herpesvirus 6, Mycoplasma pneumoniae, Borrelia burgdorferi, influenza A and B virus, picorna, cytomegalovirus, parainfluenza virus, respiratory syncytial virus, coxsackie B5 virus, adenovirus, enterovirus, Chlamydia psittaci, and Toxoplasma gondii. 7 In the study conducted by Kanerva et al, the most frequent cause of PFP in children was Borrelia burgdorferi infection, followed in decreasing order by infection with varicella zoster virus (with or without concomitant adenovirus infection), influenza A, herpes simplex virus 1, human herpesvirus 6, and Mycoplasma pneumoniae. 7 Lip pursing in patients with PFP is performed by the asymmetrical contraction of the orbicular muscle of the lips and perioral muscles, with the traction of the anatomical myofacial structures to the unaffected side.…”

Section: Introductionmentioning

confidence: 96%

“…7 In the study conducted by Kanerva et al, the most frequent cause of PFP in children was Borrelia burgdorferi infection, followed in decreasing order by infection with varicella zoster virus (with or without concomitant adenovirus infection), influenza A, herpes simplex virus 1, human herpesvirus 6, and Mycoplasma pneumoniae. 7 Lip pursing in patients with PFP is performed by the asymmetrical contraction of the orbicular muscle of the lips and perioral muscles, with the traction of the anatomical myofacial structures to the unaffected side. For the evaluation of lip incompetence, different devices were designed, which were inserted in the buccal vestibule and tractioned, such as the Ulmer oral screen or the rigid acrylic vestibular plates.…”

Section: Introductionmentioning

confidence: 96%

Lip Forces and Chewing Efficiency in Children with Peripheral Facial Paralysis

Ilea

Cristea²,

Dudescu

et al. 2015

Neuropediatrics

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Peripheral facial paralysis is accompanied by facial motor disorders and also, by oral dysfunctions. The aim of this study was to evaluate the lip forces and chewing efficiency in a group of children with peripheral facial paralysis. The degree of peripheral facial paralysis in the study group (n 11) was assessed using the House-Brackmann scale. The control group consisted of 21 children without facial nerve impairment. To assess lip forces, acrylic vestibular plates of three sizes were used: large (LVP), medium (MVP) and small (SVP). The lip force was recorded with a force transducer coupled with the data acquisition system. Masticatory efficiency was evaluated by the ability to mix two differently colored chewing gums. The images were processed with Adobe Photoshop CS3 (Delaware Corporation, San Jose, California, United States) and the number of pixels was quantified with the Image J software (DHHS/NIH/NIMH/RSB, Maryland, United States). For statistical analysis, the following statistical analysis were used: Pearson or Spearman correlation coefficient, multiple linear regression analysis, multiple logistic regression analysis, and optimal cutoff values for muscular dysfunction. There were statistically significant differences between lip forces in the following three groups: p=0.01 (LVP), p=0.01 (MVP), and p=0.008 (SVP). The cutoff values of lip forces in the study group were as follows: 7.08 N (LVP), 4.89 N (MVP), and 4.24 N (SVP). There were no statistically significant differences between the masticatory efficiency in the two groups (p=0.25). Lip forces were dependent on the degree of peripheral facial paralysis and age, but not on gender. In peripheral facial paralysis in children, a significant decrease of lip forces, but not masticatory efficiency, occurs.

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“…Bell's palsy is an acute peripheral facial paralysis of unknown cause, with an annual incidence of 11–40 per 100 000 . Its cause remains unknown, although the findings of many studies have suggested that it is primarily due to viral infection, including infection with herpes simplex (HSV), Epstein–Barr and varicella zoster viruses . In particular, the detection of HSV in the human geniculate ganglion and of the HSV genome in endoneurial fluid in Bell's palsy patients strongly suggests that infection with HSV can cause Bell's palsy .…”

Section: Introductionmentioning

confidence: 99%

Steroid plus antiviral treatment for Bell's palsy

et al. 2014

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Abstract. Kang HM, Jung SY, Byun JY, Park MS, Yeo SG (Kyung Hee University, Seoul, Korea). Steroid plus antiviral treatment for Bell's palsy. J Intern Med 2015; 277: 532-539.Objectives. The effectiveness of antiviral agents for the treatment of Bell's palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bell's palsy.Subjects and design. A total of 1342 patients diagnosed with Bell's palsy who visited the Kyung Hee Medical Center in Seoul, Korea, from 2002 to 2012 were included in this study. Patients in the S + A group were treated with prednisolone and antiviral agents (n = 569) and those in the S group with prednisolone alone (n = 773). Outcomes were measured using the House-Brackmann (HB) scale according to age, initial disease severity, electroneurography (ENoG) findings and underlying comorbidities.Results. The rate of recovery (HB grades I and II) with initially severe Bell's palsy (HB grades V and VI) was higher in the S + A than in the S group (P = 0.001). However, the rates of recovery were similar with initially moderate palsy (HB grades II-IV) (P = 0.502). In patients classified according to age and ENoG-determined severity of palsy, the overall recovery rate was higher in the S + A than in the S group, but the differences were not statistically significant (P > 0.05 for both). The recovery rate without diabetes mellitus (DM) and hypertension (HTN) was higher in the S + A group than in the S group (P = 0.031). But in the patients with HTN and DM, the difference in recovery rates between the S + A and S groups was not statistically significant (P = 0.805).Conclusions. Treatment with a steroid plus antiviral agent resulted in significantly higher recovery rates than steroid therapy alone in patients with initially severe Bell's palsy and without either HTN or DM, and a nonsignificant trend towards higher recovery rates in all patients with Bell's palsy in this study. Antiviral agents may therefore help in the treatment of Bell's palsy.

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Microbiologic Findings in Acute Facial Palsy in Children

Cited by 25 publications

References 21 publications

Are There Undiagnosed TBE-, Herpes- or Enteroviral Infections among Children Being Evaluated for Lyme Neuroborreliosis?

Are There Undiagnosed TBE-, Herpes- or Enteroviral Infections among Children Being Evaluated for Lyme Neuroborreliosis?

Lip Forces and Chewing Efficiency in Children with Peripheral Facial Paralysis

Steroid plus antiviral treatment for Bell's palsy

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