Cases reported "Bell Palsy"

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1/7. Bell's palsy during interferon therapy for chronic hepatitis c infection in patients with haemorrhagic disorders.

    Two adult patients with life-long severe haemorrhagic disorders commenced on interferon-alpha2b therapy for chronic hepatitis c infection. Both developed Bell's palsy several weeks after commencing therapy, They were started on steroids and, in addition, the first patient discontinued interferon-alpha2b therapy while the second patient elected to continue with therapy. In both cases facial paralysis improved over the ensuing weeks. Bell's palsy is often idiopathic but has been reported. in association with herpesviruses. It is not a recognised complication of chronic hepatitis b or C infection, or interferon-alpha2b therapy. However, the interferons are associated with numerous adverse reactions including various neuropsychiatric manifestations and neurological syndromes. There are several reports of nerve palsies, including optic tract neuropathy, occurring during interferon therapy, and immune-based mechanisms are thought to play a role in the aetiopathogenesis. No reports of Bell's palsy in association with interferon therapy were identified in our literature search, although one possible case has been reported to the Committee of safety in medicine. Although Bell's palsy in our patients may have occurred by chance, a neuropathic effect of interferon-alpha2b on the facial nerve cannot be excluded and we urge physicians using interferons to be aware of this potential side-effect.
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ranking = 1
keywords = herpes
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2/7. Atypical brainstem encephalitis caused by herpes simplex virus 2.

    BACKGROUND: herpes simplex encephalitis is one of the most common and serious sporadic encephalitides of immunocompetent adults. herpes simplex virus 2 (HSV-2) infections of the central nervous system usually manifest as subacute encephalitis, recurrent meningitis, myelitis, and forms resembling psychiatric syndromes. OBJECTIVES: To report and discuss magnetic resonance imaging (MRI) findings and clinical features in atypical brainstem encephalitis and facial palsy associated with HSV-2. SETTING: neurology department of a tertiary referral center. PATIENT: A 37-year-old woman was admitted to the hospital with fever, diplopia, left hemiparesis, sensory change in the face and limbs, personality changes, frontal dysexecutive syndrome, and a stiff neck. Brain MRI showed multifocal high-signal intensities in the pons, midbrain, and frontal lobe white matter on T2-weighted and fluid-attenuated inversion recovery images. cerebrospinal fluid (CSF) polymerase chain reaction (PCR) amplification analysis was positive for HSV-2. acyclovir therapy was started, and the encephalitic symptoms disappeared with a negative conversion of HSV-2 PCR in the CSF. However, after the discontinuation of acyclovir therapy, peripheral facial palsy occurred on the left side. A possible relapse or delayed manifestation of the HSV-2 infection was suspected, and the acyclovir therapy was restarted. A complete remission was achieved 3 days after the treatment. She was discharged without any neurologic sequelae. CONCLUSIONS: We describe a patient who developed atypical encephalitis due to HSV-2 and peripheral facial palsy, which could also be related to the HSV-2. This case suggests that HSV-2 should be considered among the possible causes of atypical or brainstem encephalitis and that the PCR amplification method of the CSF can help reveal the possible cause of HSV-2.
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ranking = 26.972979352925
keywords = encephalitis, herpes
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3/7. Retroauricular pain preceding Bell's palsy: report of three cases and clinical analysis.

    A retroauricular pain (RAP) ipsilateral to the side of facial paralysis (FP), often experienced patients with Bell's palsy, usually occurs around the onset of FP. Whether RAP is a risk factor for incomplete recovery from FP is controversial. This paper reports three patients with Bell's palsy in whom acute RAP preceded FP by several days. The intervals between the onset of RAP and FP were 6, 12, and 12 days, and the quality of RAP was dull/tight or neuralgic. All patients received prednisolone and acyclovir orally, and their facial functions recovered within 8 weeks. Based on the serological tests, FP was diagnosed as due to varicella-zoster virus in two patients and as idiopathic in the other. Among 58 consecutive patients with Bell's palsy, including the three patients described, 26 (44.8%) experienced RAP, the onset of which ranged from 12 days before to 2 days after the onset of FP. While the prognosis of FP was not different between patients with and without RAP, FP recovered well in all seven patients in whom RAP preceded the onset of FP by 4 days or more. These findings suggest that RAP preceding by several days may predict the good prognosis of FP. As RAP can be a preceding symptom of acute FP, patients with acute RAP require medical attention for at least 2 weeks.
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ranking = 20.546092507758
keywords = zoster, varicella
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4/7. Acute onset of facial nerve palsy associated with lyme disease in a 6 year-old child.

    Pediatric facial nerve palsy (FNP) can result from a variety of etiologies including lyme disease, varicella, primary gingivostomatitis, herpes zoster oticus (Ramsay Hunt syndrome), coxsackievirus, trauma, otitis media, hiv, diseases causing tumors or demyelinations, compressions, and possibly Epstein Barr virus. lyme disease has been implicated as the cause of over 50% of the FNPs in children. The paralysis of the facial nerve disturbs motor function to the muscles of facial expression and results in a flaccid appearance of the face (unilateral or bilateral). This case report derails undiagnosed lyme disease presenting as a facial palsy in a 6 year, 5 month-old white female. The palsy was recognized and consultation with the child's physician prompted definitive diagnosis and treatment. A review of the literature and the implications of facial nerve palsy are discussed.
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ranking = 35.282709765922
keywords = zoster, herpes zoster, varicella, herpes
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5/7. acyclovir responsive brain stem disease after the Ramsay Hunt syndrome.

    We report an immunocompetent patient with the Ramsay Hunt syndrome (RHS) followed days later by brainstem disease. Extensive virological studies proved that varicella zoster virus (VZV) was the causative agent. Treatment with intravenous acyclovir resulted in prompt resolution of all neurological deficits except peripheral facial palsy. This case demonstrates that after geniculate zoster, brainstem disease may develop even in an immunocompetent individual and effective antiviral therapy can be curative.
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ranking = 67.41821242324
keywords = varicella zoster, zoster, varicella
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6/7. Subdural empyema and herpes zoster syndrome (Hunt syndrome) complicating removal of third molars.

    We report a case of subdural empyema and herpes zoster syndrome (Hunt syndrome) complicating routine removal of third molars. Subdural empyema is an extremely rare but life-threatening complication of dental sepsis arising spontaneously or after dental surgery. The clinician should be familiar with its presentation and have a high index of suspicion, because late recognition and delay in its treatment can increase the associated morbidity and mortality. Surgical procedures and in particular maxillofacial surgery have also been known to trigger varicella zoster reactivation resulting in Hunt syndrome. Some patients develop the characteristic rash several days after the onset of facial weakness, so that Hunt syndrome may initially be misdiagnosed as Bell's palsy. We highlight the difficulties in diagnosing Hunt syndrome and argue the case for early treatment of all patients with Hunt syndrome and Bell's palsy with a combination of systemic steroids and antiviral drugs.
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ranking = 201.71058551887
keywords = varicella zoster, zoster, herpes zoster, varicella, herpes
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7/7. Bell's palsy with ipsilateral numbness.

    Bell's palsy is an idiopathic facial palsy of the peripheral type. A herpes virus is the most likely mechanism. We report a patient with the often encountered combination of a facial palsy with ipsilateral sensory changes. magnetic resonance imaging showed had contrast enhancement in the greater petrosal nerve. Viral spread through anatomical connections could be an explanation for the association of facial palsy with numbness.
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ranking = 1
keywords = herpes
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