Acute Peripheral Facial Palsy Part of a Cranial Polyneuropathy

• In 14 of 16 consecutive patients with acute peripheral facial palsy, one or more (up to four) other nerves were involved. The nerves affected in addition to the facial nerve were as follows: trigeminal (ten patients), vestibular (eight), cochlear (six), vagus (one), and upper cervical (five). Virus was not isolated from any of the patients. A fourfold increase or decrease in complement-fixing antibody titers was present in eight patients (in four, varicella-zoster; in one, varicella-zoster and mumps; in two, cytomegalovirus; in one, mumps). Further, two of the patients with varicella-zoster antibodies showed clinical signs of herpes zoster oticus. About one fourth of all patients had an increase of ESR and of α 2 -globulins in serum, and two thirds of them had increased γ-globulins in CSF. Acute peripheral facial palsy seems to be part of a cranial polyneuropathy and may be caused by a viral infection. ( Arch Otolaryngol 103:641-644, 1977)