PharmacyInfectious DiseasesPharmacotherapyMolecular VirologyNeuroinfectious DiseasesVirologyAntiviral PharmacologyAntiviral PharmacotherapyAntiviral TherapyViral EpidemiologyViral InfectionsHerpes Simplex Virus ReactivationHerpesvirus Antiviral TherapyHerpesvirus ReactivationPeripheral Facial ParalysisTherapeutic TrialsVaricella-zoster Virus InfectionsVaricella-zoster Virus LatencyVaricella-zoster Virus Reactivation
A growing body of evidence links reactivation of herpesviruses (primarily varicella zoster virus and herpes simplex virus type 1) with the development of a large proportion of cases of acute peripheral facial palsy, a syndrome commonly known by its eponym, Bell's palsy. This article reviews the definition and natural history of the disease, its underlying anatomy and pathophysiology, the data linking herpetic reactivation with development of signs and symptoms, and therapeutic trials utilizing antiviral therapy. In addition, it poses the question, would earlier intervention with antivirals make a larger impact on outcomes?