末梢性顔面神経麻痺の髄液検査とウイルス抗体価

抄録

Cerebrospinal fluid (CSF) from 17 patients with peripheral facial palsy was analyzed for IgG antibodies to varicella-zoster virus (VZV) and herpes simplex virus type 1 (HSV-1).
In 3 of 11 patients who were initially considered to have Bell's palsy, later the diagnosis was changed to zoster sine herpete. In one of these 3 patients, serum antibody to VZV showed a significant rise in titer between the first and second examinations (after 10-14 days). In 2 of them, CSF antibody to VZV was positive, and CSF cell counts and protein concentration were increased above the normal range.
Of 6 patients with Hunt's syndrome, CSF cells were increased above normal in 4 and CSF antibody to VZV was positive in 3.
No patients with Bell's palsy or zoster sine herpete had positive CSF antibody for HSV-1.
In conclusion, examination of the CSF is sometimes useful to distinguish zoster sine herpete from Bell's palsy.