Vírus varicela zoster em paralisia de Bell: estudo prospectivo

Santos, Mônica Alcântara de Oliveira; Filho, H H Caiaffa; Vianna, Melissa Ferreira; Almeida, Andressa Guimarães do Prado; Lazarini, Paulo Roberto

doi:10.1590/s1808-86942010000300016

Cited by 14 publications

References 39 publications

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Early collection of saliva specimens from Bell's palsy patients: Quantitative analysis of HHV-6, HSV-1, and VZV

et al. 2014

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Bell's palsy is the most common cause of facial paralysis. Although it has been associated with diabetes mellitus, hypertension, pregnancy, and preeclampsia, the etiology of Bell's palsy remains unknown. The reactivation of latent herpes simplex virus (HSV) or varicella-zoster virus (VZV) with subsequent inflammation and entrapment of the facial nerve in the narrow labyrinthine segment has been implicated as a cause of facial paralysis, but the active role of these viruses in Bell's palsy is still discussed. This study quantified HSV-1 DNA, VZV DNA, and HHV-6 DNA in 95 saliva samples collected from patients within 48 hr from the onset of paralysis. HSV-1, VZV, and HHV-6 were detected in 13%, 3%, and 61% of patients, respectively. The detection rate did not differ significantly between patients and a control group of healthy donors. Interestingly, however, the value of HHV-6 DNA copies was significantly higher than that detected in healthy donors. In addition, the mean value of HHV-6 DNA recorded in patients who had at least a one grade improvement of palsy at the first visit was significantly lower than that detected in patients who showed no change in facial palsy grade or an increase of at least one grade. These findings call into question the role of HSV-1 and VZV in the etiology of Bell's palsy, and suggest that HHV-6 may be involved in the development of the disease or that the underlying disease mechanism might predispose patients to HHV-6 reactivation.

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Early collection of saliva specimens from Bell's palsy patients: Quantitative analysis of HHV-6, HSV-1, and VZV

et al. 2014

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Characteristics of patients with acute peripheral facial palsy showing Varicella zoster virus DNA in saliva

Chang

Lee

Shin

et al. 2018

Journal of Medical Virology

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Infection caused by Varicella zoster virus (VZV) is a common etiology of acute peripheral facial palsy (APFP). We aimed to assess the clinical significance of detecting VZV DNA from the saliva of patients with APFP. Saliva collected from 36 patients with unilateral APFP at initial visit was analyzed to detect VZV DNA by polymerase chain reaction. The House-Brackmann (HB) scale was used to evaluate FP severity on admission day, at week 2, and at weeks 10-12 after start of treatment. Among the 28 patients without rash, VZV DNA was detected in 3 patients (10.7%); 6 of 8 patients (75.0%) with rash showed VZV DNA (P = 0.001). VZV DNA-positive patients had worse hearing than VZV DNA-negative patients (P < 0.05). A significantly higher proportion of VZV DNA-negative patients (96.3%) showed complete recovery than VZV DNA-positive patients (55.6%) (P = 0.006). In conclusion, VZV DNA-positive patients had worse hearing and incomplete recovery compared to VZV DNA-negative patients, irrespective of the presence of rash. Tests for the detection of VZV DNA in saliva may be helpful for early differential diagnosis and choosing an appropriate medical treatment of APFP.

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Origin, course and distribution of the nerves to the posterosuperior wall of the external acoustic meatus

et al. 2014

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Patients with Ramsay Hunt syndrome have various clinical symptoms including vesicular rash of the external acoustic meatus and auricle. In addition to facial nerve paresis, neurological disturbances of various cranial nerves such as the acoustic nerve, glossopharyngeal nerve and vagus nerve are reported in patients of Ramsay Hunt syndrome. To understand the reasons for the clinical symptoms, we observed the nerve branches of the auricle and external acoustic meatus. We used 18 halves of 11 Japanese cadavers. All cadavers were fixed in 8% formalin and preserved in 30% ethanol. Dissection was performed under a stereomicroscope and the communication among the nerve branches was analyzed. Posterosuperior wall of the acoustic meatus was innervated by nerve branches that emerged from the tympanomastoid fissure in 17 specimens (17/18). These branches always crossed the facial canal and had more than one communicating branch with the facial nerve inside the canal (17/17) or in the petrous bone (1/17). These branches originated from the superior ganglion of the vagus. In the origin from the vagus nerve, some of these branches communicated with the glossopharyngeal nerve (3/17). In addition to these branches, the facial nerve, after originating from the stylomastoid foramen, bifurcated into two nerve branches in some specimens (7/17). Nerve branches around the external acoustic meatus and the auricle have various communications before reaching the central nervous system. The variety of communications could explain the varied symptoms of Ramsay Hunt syndrome.

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Vírus varicela zoster em paralisia de Bell: estudo prospectivo

Cited by 14 publications

References 39 publications

Early collection of saliva specimens from Bell's palsy patients: Quantitative analysis of HHV-6, HSV-1, and VZV

Early collection of saliva specimens from Bell's palsy patients: Quantitative analysis of HHV-6, HSV-1, and VZV

Characteristics of patients with acute peripheral facial palsy showing Varicella zoster virus DNA in saliva

Origin, course and distribution of the nerves to the posterosuperior wall of the external acoustic meatus

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