Abstract

Case Report

Facial Paralysıs During Varicella Zoster Infectıon in a child

Fatih Oghan*, Muhammet Fatih Topuz and Onur Erdogan

Published: 23 March, 2017 | Volume 1 - Issue 1 | Pages: 016-019

Introduction: Primary infection with varicella-zoster virus (VZV) results in chickenpox, characterized by viremia with a diffuse rash and seeding of multiple sensory ganglia, where the virus establishes lifelong latency. Herpes zoster is caused by reactivation of latent VZV in cranial-nerve or dorsal-root ganglia, with spread of the virus along the sensory nerve to the dermatome. Both entities have a benign clinical course in immunocompetent and young individuals. Although Herpes zoster virüs may result in Ramsey Hunt sendrom, it may rarely cause peripheral facial paralysis in the course of varicella.

Case report: A 4-year-old girl patient was admitted to the ear, nose, and throat clinic with a complaint of a rash over the body with vesicles and pustules a few days. She had left peripheral facial palsy about 2 days ago. In a general clinical examination, a few macular lesions, probably residues of vesicles, and fluid-filled blisters and pustules were observed on the back, chest, abdomen, upper, and lower limbs. She had remarkable left peripheral facial palsy. Her facial palsy was assessed as a grade II using the House-Brackmann Score. Otoscopic examination was normal and otalgia and auricular vesicle was absent. 1 mg/kg/day prednisone and 30 mg/kg/day acyclovir therapy were given to the patient due to the peripheral facial nerve palsy involvement of the VZV infection. Complete remission was achieved at 1 month after treatment.

Conclusion: Varicella-zoster virus (VZV) is one of eight herpes viruses known to cause human infection and is distributed worldwide. While the results of bell palsy are good, facial paralysis results during viral infections are severe. Cranial nerve involvement secondary to viral infection should be followed closely. The current standard of care for treatment is acyclovir and prednisone. Thus early treatment can be started in the face of developing complications and possible mortality and morbidity can be prevented.

Read Full Article HTML DOI: 10.29328/journal.hor.1001004 Cite this Article Read Full Article PDF

Keywords:

Varicella; Facial palsy

References

  1. Yalaki Z, Öztürk A, Taşar MA, Dallar Y. Herpes Zoster Infections In Healthy Children. Cocuk Enf Derg. 2010; 4: 96-99. Ref.: https://goo.gl/HlC0Rs
  2. Gershon AA. Varicella-zoster virus infections. Pediatr Rev. 2008; 29: 5-10. Ref.: https://goo.gl/nPFK3I
  3. Gnann JW Jr. Varicella-zoster virus: a typical presentations and unusual complications. J Infect Dis. 2002; 186: 91-98. Ref.: https://goo.gl/g0vcty
  4. Yilmaz C, Aksen HC. Severe neurological complications of chickenpox: Report of four cases. Eur J Gen Med. 2005; 2: 177-179. Ref.: https://goo.gl/deYDD5
  5. Rama Rao G, Amareswar A, Kishan Kumar Y, Rani R. Isolated facial palsy in varicella. Indian J Dermatol Venereol Leprol. 2008; 74; 261-262. Ref.: https://goo.gl/esIOVl
  6. Bozzola E, Tozzi AE, Bozzola M, Krzysztofiak A, Valentini D, et al. Neurological complications of varicella in childhood: case series and a systematic review of the literature. Vaccine. 2012; 30: 5785-5790. Ref.: https://goo.gl/UxYlfV
  7. Danovaro-Holliday MC, Gordon EJ, Jumaan AO, Woernle C, Judy RH, et al. High rate of varicella complications among Mexican-born adults in Alabama. Clin Infect Dis. 2004; 39: 1633-1639. Ref.: https://goo.gl/xRUjo5
  8. Amlie-Lefond C, Jubelt B. Neurologic manifestations of varicella zoster virus infections. Curr Neurol Neurosci Rep. 2009; 9: 430-434. Ref.: https://goo.gl/HbCusd
  9. Riaza G´omez M, De la Torre Espi M, Bartolome SM, Molina Cabanero JC, Tamariz-Martel Moreno A. [Complications of varicella in children]. An Esp Pediatr. 1999; 50: 259-262. Ref.: https://goo.gl/o48gQs
  10. Iwasaki H, Toda N, Takahashi M, Azuma T, Nakamura K, et al. Vestibular and cochlear neuritis in patients with Ramsay Hunt syndrome: a Gd-enhanced MRI study. Acta Otolaryngol. 2013; 133: 373-377. Ref.: https://goo.gl/gmTs90
  11. Gunbey HP, Kutlar G, Aslan K, Sayit AT, Incesu L. Magnetic Resonance Imaging Evidence of Varicella Zoster Virus Polyneuropathy: Involvement of the Glossopharyngeal and Vagus Nerves Associated With Ramsay Hunt Syndrome. Journal of Craniofacial Surgery. 2016; 27: 721-723. Ref.: https://goo.gl/CnoEzp
  12. Odemis E, Turkay S, Tunca A, Karadag A. Acute peripheral facial palsy during chickenpox in a child. J Pediatr Neurol. 2004; 2: 245-246. Ref.: https://goo.gl/w1UrVb
  13. Muñoz-Sellart M, García-Vidal C, Martínez-Yelamos S, Niubó J, Fernández-Viladrich P. Peripheral facial palsy after varicella. Report of two cases and review of the literature. Enferm Infecc Microbiol Clin. 2010; 28: 504-508. Ref.: https://goo.gl/RxmHaJ

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More