Acute Peripheral Facial Palsy: Part of a Cranial Polyneuropathy?

Abstract

In 14 of 16 consecutive patients with acute peripheral facial palsy, one or more (up to four) other nerves were involved. The nerves affected in addition to the facial nerve were as follows: trigeminal (ten patients), vestibular (eight), cochlear (six), vagus (one), and upper cervical (five). Virus was not isolated from any of the patients. A fourfold increase or decrease in complement-fixing antibody titers was present in eight patients (in four, varicella-zoster; in one, varicella-zoster and mumps; in two, cytomegalovirus; in one, mumps). Further, two of the patients with varicella-zoster antibodies showed clinical signs of herpes zoster oticus. About one fourth of all patients had an increase of ESR and of alpha2-globulins in serum, and two thirds of them had increased gamma-globulins in CSF. Acute peripheral facial palsy seems to be part of a cranial polyneuropathy and may be caused by a viral infection.