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Infectious causes of peripheral facial nerve palsy in children—a retrospective cohort study with long-term follow-up

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

The aim of this study was to analyze the clinical and laboratory characteristics of children with peripheral facial nerve palsy (pFP) with a focus on identifying infectious etiology and long-term outcome. We conducted an ICD-10-based retrospective chart review on children hospitalized with pFP between January 1, 2006, and December 31, 2016. Furthermore, a telephone-based follow-up survey was performed. A total of 158 patients were identified, with a median age of 10.9 years (interquartile range 6.4–13.7). An infectious disease was associated with pFP in 82 patients (51.9%); 73 cases were classified as idiopathic pFP (46.2%). Three cases occurred postoperatively or due to a peripheral tumor. Among the infectious diseases, we identified 33 cases of neuroborreliosis and 12 viral infections of the central nervous system (CNS), caused by the varicella-zoster virus, human herpesvirus 6, herpes simplex virus, enterovirus, and Epstein-Barr virus. Other infections were mainly respiratory tract infections (RTIs; 37 cases). Children with an associated CNS infection had more often headache and nuchal rigidity, a higher cerebrospinal fluid cell count, and a longer length of hospital stay. Long-term follow-up revealed an associated lower risk of relapse in CNS infection–associated pFP. Among all groups, permanent sequelae were associated with female sex, a shorter length of hospitalization, and a lower white blood cell count at presentation. pFP is frequently caused by an CNS infection or is associated with concurrent RTIs, with a potential impact on the short- and long-term clinical course.

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Acknowledgments

We thank all patients and their parents for their willingness to participate in this study. We are grateful to Michael Karremann for his support in data collection.

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Authors and Affiliations

  1. Pediatric Infectious Diseases, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Cihan Papan, Leonie Kremp, Horst Schroten & Tobias Tenenbaum

  2. Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, 66421, Homburg, Germany

    Cihan Papan

  3. Institute of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Christel Weiß

  4. Institute of Medical Microbiology and Hygiene, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Angela Petzold

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  1. Cihan Papan
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  2. Leonie Kremp
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  4. Angela Petzold
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  6. Tobias Tenenbaum
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Correspondence to Cihan Papan.

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This study was approved by the ethics committee of the Medical Faculty Mannheim, Heidelberg University (2017-541N-MA). Informed consent was obtained from patients prior to the follow-up interview.

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Papan, C., Kremp, L., Weiß, C. et al. Infectious causes of peripheral facial nerve palsy in children—a retrospective cohort study with long-term follow-up. Eur J Clin Microbiol Infect Dis 38, 2177–2184 (2019). https://doi.org/10.1007/s10096-019-03660-6

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