Department of Clinical Microbiology, University Hospital of Southern Denmark, Soenderborg/Aabenraa.
Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital.
Dan Med J. 2022 Aug 16;69(9):A07210575.
Several infectious aetiologies have been associated with peripheral facial palsy, among others Herpes viridae and Borrelia burgdorferi and, rarely, cases of rickettsiosis. In this study, we prospectively included 19 patients with peripheral facial palsy from the Department of Neurology, University Hospital of Southern Denmark, and 29 healthy controls to examine infectious causes and risk factors of peripheral facial palsy.
Patients and controls completed a questionnaire regarding exposures, and the patients' medical files were examined. Serum from patients and controls were tested for antibodies against B. burgdorferi, Rickettsia felis and Rickettsia helvetica. Cerebrospinal fluids were tested using polymerase chain reaction for the presence of herpes simplex virus 1 and 2, herpes zoster virus and spotted fever group rickettsial DNA and for intrathecal production of antibodies against B. burgdorferi with an antibody index test.
One patient was diagnosed with peripheral facial palsy associated with neuroborreliosis with a positive antibody index test but had a negative serological analysis. No patients had evidence of herpes or rickettsial infection. Fourteen out of the 19 patients had symptom onset in the winter months. Preceding myalgia was the only significant difference in symptoms between patients and controls (p = 0.011).
Rickettsiosis is unlikely as a common cause of facial palsy in Southern Jutland, Denmark.
The study was supported financially by the Knud and Edith Eriksen Mindefond and the Region of Southern Denmark.
The study population and the control group were approved by the Regional Committees on Health Research Ethics for Southern Denmark (S-20170136 and S-20170049) and by the Danish Data Protection Agency (17/31901 and 18/28928). All participants provided informed consent before their enrollment in the study.
多种感染病因与周围性面瘫有关，包括疱疹病毒和伯氏疏螺旋体，以及罕见的立克次体病。在这项研究中，我们前瞻性地纳入了来自丹麦南丹麦大学医院神经内科的 19 名周围性面瘫患者和 29 名健康对照者，以检查周围性面瘫的感染病因和危险因素。
患者和对照者完成了一份有关暴露情况的问卷，并且检查了患者的病历。从患者和对照者中抽取血清，检测针对伯氏疏螺旋体、猫抓病立克次体和五日热巴通体的抗体。使用聚合酶链反应检测疱疹病毒 1 型和 2 型、带状疱疹病毒和斑点热群立克次体 DNA 在脑脊液中的存在情况，并使用抗体指数试验检测针对伯氏疏螺旋体的鞘内抗体产生情况。
1 名患者被诊断为与神经伯氏疏螺旋体病相关的周围性面瘫，抗体指数试验阳性，但血清学分析为阴性。没有患者有疱疹或立克次体感染的证据。19 名患者中有 14 名在冬季发病。与对照组相比，患者的症状中仅有肌痛是唯一显著的差异（p = 0.011）。
在丹麦南日德兰，立克次体病不太可能是面瘫的常见病因。
本研究得到了 Knud 和 Edith Eriksen 基金会和南丹麦地区的财政支持。
研究人群和对照组均获得了南丹麦地区卫生研究伦理委员会（S-20170136 和 S-20170049）和丹麦数据保护局（17/31901 和 18/28928）的批准。所有参与者在入组前均签署了知情同意书。
