HIV and acute peripheral facial nerve palsy

Abstract

Between April and December 1989, 32 consecutive patients referred to the neurology clinic with acute peripheral facial paralysis were studied. Patients with traumatic facial palsy, parotid gland disease, otitis media and meningitis were excluded. Each of the patients selected had HIV test done by ELISA and the positive ones confirmed by Western blot. 8 (25%) of the patients tested positive for HIV antibodies. Their mean age was 34 +/- 13 years with an age range of 15-53 years. 4 (50%) of the 8 seropositive patients had generalized lymphadenopathy, one herpes zoster, one generalized pruritic rash, two of the patients were asymptomatic. The seroprevalence of HIV antibodies in patients with acute peripheral facial paralysis is much lower than that reported in other African countries. PIP: Between April-December 1989, physicians at the neurology clinic of the Kenyatta National Hospital in Nairobi, Kenya recruited 32 patients who exhibited facial nerve palsy of lower motor neuron type and who did not have any trauma, inflammation of the middle ear, surgery, or disease of the parotid gland. 8 (25%) of the patients were HIV seropositive. Researchers did not retest any of the seronegative patients for HIV. 6 of the HIV seropositive cases had symptoms of early HIV infection: 4 generalized lymphadenopathy, 1 herpes zoster, and 1 generalized pruritic rash. The 2 other HIV seropositive patients did not have any symptoms other than facial paralysis. Several other studies have demonstrated an association between HIV infection and acute peripheral facial paralysis, especially in asymptomatic or AIDS related complex patients. In a study in Bangui, Central African Republic, HIV seroprevalence among patients with acute peripheral facial paralysis was 69%. The researchers could not identify the reason for the difference between the HIV seroprevalences of the 2 studies. Nevertheless physicians should expect to treat more cases of acute peripheral facial paralysis as the prevalence of HIV increases