Bell's palsy causes: Difference between revisions
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==Causes== | ==Causes== | ||
Many cases are likely due to [[Herpes Simplex Virus]] (HSV) reactivation | Many cases are likely due to [[Herpes Simplex Virus]] (HSV) reactivation | ||
===Infectious Causes=== | |||
*[[Herpes simplex virus]] activation is the most likely cause of Bell's Palsy. | |||
*[[Herpes Zoster]] may be the second most common viral infection. | |||
*[[Cytomegalovirus]] | |||
*[[Epstein Barr virus]] | |||
*[[Adenovirus]] | |||
*[[Rubella]] virus | |||
*[[Mumps]] | |||
*[[Influenza B]] | |||
*[[Coxsackie]] virus | |||
*Rickettsial infection | |||
*[[Ehrlichiosis]] | |||
*Borrelia burdopheri | |||
*[[HIV]] | |||
===Non-Infectious Causes=== | |||
*Several cases of Bell' Palsy were linked to an inactivated intranasal influenza vaccine in Switzerland | |||
*Genetic predisposition may be likely | |||
*[[Ischemia]] of the facial nerve | |||
*Tumors and compression of the facial nerve | |||
*Temporal bone fracture | |||
*Systemic Lupus Erythematosus ([[SLE]]) | |||
*[[Sarcoidosis]] | |||
===Lyme Disease=== | ===Lyme Disease=== | ||
*Facial nerve palsy is the most common cranial [[neuropathy]] associated with Lyme meningitis. | |||
*Screening for antibodies to B.burgdorferi not recommended among patients with seventh nerve palsy with no additional manifestations of Lyme disease. | |||
*Findings suggestive of possible [[Lyme disease]] include the development of facial palsy in a young patient, heart block, arthritis, vertigo, and hearing loss. | |||
===HIV=== | ===HIV=== | ||
*HIV infection rarely causes facial palsy. | |||
*Onset at the time of sero-conversion when a [[CSF]] lymphocytosis is usually present. | |||
*In the later stages when cellular immunity wanes, the facial palsy is typically due to another infection such as Zoster, chronic demyelinating polyradiculopathy, or meningeal [[lymphomatosis]]. | |||
===Melkersson-Rosenthal Syndrome=== | ===Melkersson-Rosenthal Syndrome=== | ||
*Facial paralysis, episodic facial swelling, and a fissured tongue, typically beginning in adolescence, with recurrent episodes of facial palsy. | |||
*Incomplete forms of this syndrome outnumber those with the classic triad. | |||
*The cause is unknown, and treatment unproven. | |||
===Other Entities=== | ===Other Entities=== | ||
*Bacterial infection of the middle ear ([[otitis media]]) | |||
*[[Cholesteatoma]], or tumors should be suspected if the onset of facial palsy is gradual. | |||
*[[Sarcoidosis]], especially in patients with bilateral facial palsy. | |||
*[[Sjogren's syndrome]] is an unusual cause. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 18:38, 26 March 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
Many cases are likely due to Herpes Simplex Virus (HSV) reactivation
Infectious Causes
- Herpes simplex virus activation is the most likely cause of Bell's Palsy.
- Herpes Zoster may be the second most common viral infection.
- Cytomegalovirus
- Epstein Barr virus
- Adenovirus
- Rubella virus
- Mumps
- Influenza B
- Coxsackie virus
- Rickettsial infection
- Ehrlichiosis
- Borrelia burdopheri
- HIV
Non-Infectious Causes
- Several cases of Bell' Palsy were linked to an inactivated intranasal influenza vaccine in Switzerland
- Genetic predisposition may be likely
- Ischemia of the facial nerve
- Tumors and compression of the facial nerve
- Temporal bone fracture
- Systemic Lupus Erythematosus (SLE)
- Sarcoidosis
Lyme Disease
- Facial nerve palsy is the most common cranial neuropathy associated with Lyme meningitis.
- Screening for antibodies to B.burgdorferi not recommended among patients with seventh nerve palsy with no additional manifestations of Lyme disease.
- Findings suggestive of possible Lyme disease include the development of facial palsy in a young patient, heart block, arthritis, vertigo, and hearing loss.
HIV
- HIV infection rarely causes facial palsy.
- Onset at the time of sero-conversion when a CSF lymphocytosis is usually present.
- In the later stages when cellular immunity wanes, the facial palsy is typically due to another infection such as Zoster, chronic demyelinating polyradiculopathy, or meningeal lymphomatosis.
Melkersson-Rosenthal Syndrome
- Facial paralysis, episodic facial swelling, and a fissured tongue, typically beginning in adolescence, with recurrent episodes of facial palsy.
- Incomplete forms of this syndrome outnumber those with the classic triad.
- The cause is unknown, and treatment unproven.
Other Entities
- Bacterial infection of the middle ear (otitis media)
- Cholesteatoma, or tumors should be suspected if the onset of facial palsy is gradual.
- Sarcoidosis, especially in patients with bilateral facial palsy.
- Sjogren's syndrome is an unusual cause.