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Neurological Sciences

, Volume 33, Issue 4, pp 951–953 | Cite as

Idiopathic bilateral facial palsy: is a causative role of anti-GM1 ganglioside and herpes simplex type 1 possible?

  • Elena Pretegiani
  • Francesca Rosini
  • Donatella Donati
  • Alessandra Rufa
  • Donatella Moschettini
  • Alfonso Cerase
  • Alessandra Morucci
  • Pasquale Annunziata
  • Antonio Federico
Letter to the Editor

Dear Sir,

Bilateral facial nerve palsy (FP) is a rare clinical entity often idiopathic or secondary to several diseases [1]. A role of Herpes simplex virus type 1 (HSV-1) in idiopathic FP is under debate [2]. We report here on a case of bilateral FP associated with anti-GM1 ganglioside antibodies and cerebrospinal HSV-1 DNA, who recovered after therapy with intra-venous immunoglobulins (IVIg).

A 68-year-old woman presented a sudden complete right sided FP that, despite treatment (methylprednisolone 40 mg/day i.m.), became bilateral in 1 week. The clinical history was devoid of relevant pathological events. At day 10 from the onset of symptoms, a neurological examination showed bilateral complete lower motor neuron FP (House-Brackmann grading system V on right and IV on left side). Meanwhile, there was no evidence of motor or sensory impairment of other cranial nerves and limbs, and deep tendon reflexes were normal. Neurophysiology, which included nerve conduction studies, motor,...

Keywords

Facial Nerve Palsy IVIg Therapy Miller Fisher Syndrome Bilateral Facial Nerve Palsy Idiopathic Facial Nerve Palsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Elena Pretegiani
    • 1
  • Francesca Rosini
    • 1
  • Donatella Donati
    • 1
  • Alessandra Rufa
    • 1
  • Donatella Moschettini
    • 3
  • Alfonso Cerase
    • 2
  • Alessandra Morucci
    • 1
  • Pasquale Annunziata
    • 1
  • Antonio Federico
    • 1
  1. 1.Department of Neurological, Neurosurgical and Behavioural SciencesUniversity of SienaSienaItaly
  2. 2.UOC NINT,–Department of Neurosciences“Santa Maria alle Scotte” HospitalSienaItaly
  3. 3.Department of Molecular BiologyUniversity of SienaSienaItaly

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