Abstract
Objective
Recurrent facial palsy is relatively rare and its clinical details of recurrent facial
palsy are not well known. We analyzed recurrent facial palsy cases and clarified its
characteristics, especially the difference between ipsilateral and alternative palsies.
The analysis aimed to obtain information about recurrent facial palsy that would be
useful for delivering explanations to patients and help improve recurrent facial palsy
treatments based on the etiology.
Methods
We picked up data from the chart and analyzed the clinical characteristics of patients
with recurrent facial palsy from 1243 facial palsy patients (Bell's palsy, VZV-related
palsy (Ramsay Hunt syndrome and zoster sine herpete [ZSH])) between 2006 and 2020.
Results
Recurrent facial palsy was observed in 104 of 1243 patients (8.4%). There were 35
cases (34%) of ipsilateral palsy and 69 cases (66%) of alternative palsy. The mean
age at the onset of the first palsy was 38.9 years old in the ipsilateral group and
48.4 years old in the alternative group, and a significant difference was observed
between them. The number of recurrences ranged from 1 to 4. Among the ipsilateral
group, 6 patients experienced more than second recurrence. In two cases, the condition
failed to resolve after the second recurrence. A serological examination confirmed
that 4 cases had recurrent VZV-related palsy (both the first and second palsies were
VZV-related) and all of them initially had ZSH: no cases had Hunt syndrome as the
first palsy.
Conclusions
The VZV-specific immunity obtained with ZSH might be insufficient to suppress VZV
reactivation, and VZV vaccination should be recommended for ZSH patients to prevent
further recurrence of VZV-related facial palsy. More than 2 ipsilateral recurrent
episodes may be a risk factor for incomplete recovery.
Keywords
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Article info
Publication history
Published online: December 08, 2022
Accepted:
November 21,
2022
Received:
May 21,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
