FACIAL PALSY IN KAWASAKI-SYNDROME

Facial nerve palsy, a very rare complication of Kawasaki syndrome, has been reported in only 25 patients, We treated a 12-week-old boy with bilateral coronary artery aneurysms due to Kawasaki syndrome who devel oped marked unilateral peripheral facial nerve palsy on day 36 of illn ess, None of the 25 previously reported patients with this complicatio n were treated with immunoglobulin; they required 7 to 90 days to reco ver, In our patient, treatment with this agent was associated with com plete resolution of facial nerve palsy within 36 hours, Review of prio r eases demonstrates that children with Kawasaki-associated facial ner ve palsy have more than twice the risk for coronary artery aneurysm (5 2% vs <25%) as that of children who do not develop this neurological c omplication, Unexplained facial nerve paralysis in young children with a prolonged febrile illness should provoke consideration of Kawasaki syndrome and of echocardiography to exclude coronary artery aneurysms, Although facial palsy appears likely to resolve in all patients that survive the acute phase of Kawasaki syndrome, treatment with intraveno us immunoglobulin appears to considerably shorten the time to full rec overy and provides an important clue to the mechanisms of neurological injury in this illness. (C) 1997 by Elsevier Science me. All rights r eserved.