BELL PALSY AND HERPES-SIMPLEX VIRUS - IDENTIFICATION OF VIRAL-DNA IN ENDONEURIAL FLUID AND MUSCLE

Objective: To determine whether herpes simplex virus type 1 (HSV-1) ca uses Bell palsy. Design: Prospective study. Setting: University inpati ent service. Patients: 14 patients with Bell palsy, 9 patients with th e Ramsay-Hunt syndrome, and 12 other controls. Measurements: Viral gen omes of HSV-1, varicella-zoster virus, and Epstein-Barr virus were ana lyzed in clinical samples of facial nerve endoneurial fluid and poster ior auricular muscle using polymerase chain reaction (PCR) followed by hybridization with Southern blot analysis. Results: Herpes simplex vi rus type 1 genomes were detected in 11 of 14 patients (79%) with Bell palsy but not in patients with the Ramsay-Hunt syndrome or in other co ntrols. The nucleotide sequences of the PCR fragments were identical t o those of the HSV-1 genome. Conclusions: Herpes simplex virus type 1 is the major etiologic agent in Bell palsy.