Morgan M, Nathwani D
Department of Microbiology, Aberdeen Royal Infirmary, Scotland.
Clin Infect Dis. 1992 Jan;14(1):263-71. doi: 10.1093/clinids/14.1.263.
While it is now universally accepted that Ramsay Hunt syndrome is caused by varicella-zoster virus, Bell's palsy continues to be labeled "idiopathic." We review the literature associating Bell's palsy with various infectious agents as well as with Kawasaki disease, a condition in which an infectious etiology is suspected. Good evidence--mostly serological--exists for an etiologic role for the herpes group of viruses, mumps virus, and rubella virus. In addition, recent evidence has focused on Bell's palsy in human immunodeficiency virus infection and Lyme borreliosis. In view of the multiplicity of implicated agents, it is likely that the immunologic response associated with infection triggers a cranial or generalized polyneuropathy culminating in facial nerve compression, degeneration, and paralysis. The mounting interest in Bell's palsy, coupled with the increasing availability of more sensitive and specific tests, is likely to augment the available evidence for an infectious etiology and to clarify the role of other, previously unsuspected infectious agents.
虽然目前人们普遍认为拉姆齐·亨特综合征是由水痘-带状疱疹病毒引起的，但贝尔麻痹仍被归类为“特发性”。我们回顾了将贝尔麻痹与各种感染因子以及川崎病（一种怀疑有感染病因的疾病）相关联的文献。有充分的证据——主要是血清学证据——表明疱疹病毒组、腮腺炎病毒和风疹病毒具有病因学作用。此外，最近的证据集中在人类免疫缺陷病毒感染和莱姆病中的贝尔麻痹。鉴于涉及的病原体种类繁多，与感染相关的免疫反应很可能引发颅神经或全身性多发性神经病，最终导致面神经受压、变性和麻痹。对贝尔麻痹的兴趣日益浓厚，再加上更敏感和特异的检测方法越来越容易获得，这可能会增加支持感染病因的现有证据，并阐明其他先前未被怀疑的感染因子的作用。
