Álvarez-Argüelles Marta E, Rojo-Alba Susana, Rodríguez Pérez Mercedes, Abreu-Salinas Fátima, de Lucio Delgado Ana, Melón García Santiago
Department of Microbiology, Unit of Virology, Central University Hospital of Asturias, Oviedo, Spain.
Department of Paediatric, Central University Hospital of Asturias, Oviedo, Spain.
Am J Case Rep. 2019 Aug 17;20:1216-1219. doi: 10.12659/AJCR.917318.
BACKGROUND Peripheral facial paralysis is a clinical presentation which, in most cases, is benign. It is relatively frequent, although less so in pediatric patients, where clinical diagnosis is more difficult. This clinical condition can be congenital, neurological, infectious, neoplastic, traumatic, or metabolic in origin. CASE REPORT This report describes the case of a male infant of 23 months of age with peripheral facial paralysis due to Epstein-Barr virus (EBV) upper respiratory infection. A hemogram showed the presence of leukocytosis and lymphocytosis, and a peripheral blood smear indicated the presence of stimulated lymphocytes. Serological tests were compatible with recent EBV infection: IgM anti-VCA (capsid antigen) was positive, while IgG anti-VCA and anti-EBNA (nuclear antigen) were negative. EBV genome was detected in pharyngeal swab and in serum, where viral load was 5.08 log copies/1000 cells and 3.72 log copies/mL, respectively. CONCLUSIONS Whilst the most common cause of facial paralysis is idiopathic paralysis, such problems of the facial nerve may have many origins, including an infectious nature such as infection with viral agents. Rapid determination of the etiology of the problem allows the most appropriate management of the condition and quick follow-up to be implemented, which is essential for the evaluation of treatment response and the avoidance of permanent consequences.
周围性面瘫是一种临床表现，在大多数情况下为良性。它相对常见，尽管在儿科患者中较少见，因为儿科临床诊断更困难。这种临床状况的病因可以是先天性、神经性、感染性、肿瘤性、创伤性或代谢性的。病例报告：本报告描述了一名23个月大的男婴因爱泼斯坦-巴尔病毒（EBV）上呼吸道感染导致周围性面瘫的病例。血常规显示白细胞增多和淋巴细胞增多，外周血涂片显示有活化淋巴细胞。血清学检测结果与近期EBV感染相符：IgM抗VCA（衣壳抗原）呈阳性，而IgG抗VCA和抗EBNA（核抗原）呈阴性。在咽拭子和血清中检测到EBV基因组，病毒载量分别为5.08 log拷贝/1000细胞和3.72 log拷贝/毫升。结论：虽然面瘫最常见的原因是特发性面瘫，但面神经问题可能有多种起源，包括感染性病因，如病毒感染。快速确定问题的病因有助于实施最恰当的病情管理和快速随访，这对于评估治疗反应和避免永久性后果至关重要。
