RESUMEN
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.
Asunto(s)
Infecciones del Sistema Nervioso Central/complicaciones , Parálisis Facial/etiología , Infecciones del Sistema Respiratorio/complicaciones , Adolescente , Parálisis de Bell/complicaciones , Parálisis de Bell/patología , Parálisis de Bell/fisiopatología , Borrelia/aislamiento & purificación , Infecciones del Sistema Nervioso Central/líquido cefalorraquídeo , Infecciones del Sistema Nervioso Central/patología , Infecciones del Sistema Nervioso Central/fisiopatología , Líquido Cefalorraquídeo/citología , Líquido Cefalorraquídeo/microbiología , Líquido Cefalorraquídeo/virología , Niño , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/patología , Parálisis Facial/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Infecciones del Sistema Respiratorio/líquido cefalorraquídeo , Infecciones del Sistema Respiratorio/patología , Infecciones del Sistema Respiratorio/fisiopatología , Estudios Retrospectivos , Estaciones del Año , Virus/aislamiento & purificaciónRESUMEN
We identified 620 children with peripheral facial palsy of which 211 (34%) had Lyme disease. The 140 children who had a lumbar puncture performed were more likely to be hospitalized (73% LP performed vs 2% no LP) and to receive parenteral antibiotics (62% LP performed vs 6% no LP).
Asunto(s)
Parálisis Facial/diagnóstico , Enfermedad de Lyme/diagnóstico , Punción Espinal , Adolescente , Boston , Niño , Estudios Transversales , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/etiología , Femenino , Humanos , Enfermedad de Lyme/líquido cefalorraquídeo , Enfermedad de Lyme/complicaciones , Masculino , Estudios RetrospectivosRESUMEN
Bilateral facial nerve palsy or facial diplegia is a rare condition that occurs mainly in the context of Guillain-Barré syndrome. Its natural history has never been studied. We report four patients with isolated idiopathic bilateral facial nerve palsy with meningitis, no evidence of Guillain-Barré syndrome and rapid and complete recovery. Our report aims to draw attention to an unusual variant of bilateral facial palsy.
Asunto(s)
Enfermedades del Nervio Facial/fisiopatología , Parálisis Facial/fisiopatología , Adulto , Anciano , Proteína C-Reactiva/metabolismo , Enfermedades del Nervio Facial/líquido cefalorraquídeo , Enfermedades del Nervio Facial/diagnóstico , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/diagnóstico , Femenino , Humanos , Masculino , Conducción Nerviosa/fisiologíaAsunto(s)
Diplopía/complicaciones , Parálisis Facial/complicaciones , Proteínas Sanguíneas/metabolismo , Diplopía/líquido cefalorraquídeo , Diplopía/diagnóstico , Progresión de la Enfermedad , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/diagnóstico , Femenino , Humanos , Cadenas Pesadas de Inmunoglobulina/líquido cefalorraquídeo , Linfocitos/patología , Imagen por Resonancia Magnética , Megacariocitos/patología , Persona de Mediana Edad , Tomógrafos Computarizados por Rayos XRESUMEN
We describe a 26-year-old man treated with azathioprine for myasthenia gravis who developed acute left-sided peripheral facial weakness. Brain magnetic resonance imaging (MRI) revealed enhancement in the left geniculate ganglion and in the intracanalicular and tympanic segments of the facial nerve. Analysis of cerebrospinal fluid (CSF) and serum revealed intrathecal synthesis of anti-varicella zoster virus (VZV) IgG antibody. Although previous analyses of saliva, blood mononuclear cells, serum antibodies, middle ear fluid, and auricular and geniculate zone skin scrapings have shown that a small but definite proportion of patients with idiopathic peripheral facial palsy ("Bell's palsy") have the Ramsay Hunt syndrome zoster sine herpete (RHS ZSH), this is the first confirmation of RHS ZSH by intrathecal synthesis of anti-VZV IgG antibody. In addition, herpes simplex virus (HSV)-1 DNA was found in saliva of the patient on 3 consecutive days. Simultaneous reactivation of two alphaherpesviruses (HSV-1 and VZV) in our immunosuppressed patient underscores the need to consider opportunistic infection as a cause of facial weakness.
Asunto(s)
Parálisis Facial/líquido cefalorraquídeo , Herpes Simple/líquido cefalorraquídeo , Herpes Zóster/líquido cefalorraquídeo , Herpesvirus Humano 1/fisiología , Herpesvirus Humano 3/fisiología , Huésped Inmunocomprometido , Enfermedad Aguda , Adulto , Parálisis Facial/diagnóstico , Parálisis Facial/virología , Herpes Simple/diagnóstico , Herpes Zóster/diagnóstico , Humanos , Masculino , Recurrencia , Activación Viral/fisiologíaAsunto(s)
Hipotensión Intracraneal/etiología , Imagen por Resonancia Magnética , Cefalea Pospunción de la Duramadre/diagnóstico , Trombosis de los Senos Intracraneales/etiología , Punción Espinal/efectos adversos , Anticoagulantes/uso terapéutico , Parche de Sangre Epidural , Medios de Contraste , Parálisis Facial/líquido cefalorraquídeo , Femenino , Gadolinio , Humanos , Imagenología Tridimensional , Hipotensión Intracraneal/diagnóstico , Angiografía por Resonancia Magnética , Cefalea Pospunción de la Duramadre/complicaciones , Cefalea Pospunción de la Duramadre/patología , Cefalea Pospunción de la Duramadre/terapia , Postura , Recurrencia , Trombosis de los Senos Intracraneales/diagnóstico , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Vómitos/etiología , Adulto JovenRESUMEN
We investigated the pattern of volitional facial motor deficits in acute stroke patients. We assessed the strength of single facial movements and correlated it to the site of infarct classified on computed tomography scans. Exclusion criteria were previous stroke, cerebral hemorrhage, and subcortical stroke. Results showed that weakness in eyelid closure was associated with anterior cerebral artery (ACA) stroke. Weakness in lip opening was associated with middle cerebral artery (MCA) stroke. We suggest that sparing of upper facial movements in MCA stroke is due to the presence of an upper face motor representation in both the MCA and ACA territories.
Asunto(s)
Parálisis Facial/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales Humanizados , ADN Viral/líquido cefalorraquídeo , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/tratamiento farmacológico , Parálisis Facial/etiología , Femenino , Humanos , Virus JC/metabolismo , Leucoencefalopatía Multifocal Progresiva/inducido químicamente , Modelos Logísticos , Masculino , Persona de Mediana Edad , Movimiento/efectos de los fármacos , Natalizumab , Estadísticas no Paramétricas , Accidente Cerebrovascular/complicacionesRESUMEN
The frequency of taste disorders in idiopathic facial palsy (IFP) and B. burgdorferi-associated facial palsy (BFP) was retrospectively assessed in a cohort of patients with acute peripheral facial palsy (AFP). A significant (>10/microl) CSF pleocytosis was found in 17% of the patients who underwent lumbar puncture for AFP. In two centres, 26 patients with BFP were identified by CSF and serological criteria. The control group (patients with IFP) consisted of 59 patients from one of the centres in whom BFP was excluded by CSF examination. AFP patients of both centres are routinely questioned about taste disorders according to the hospitals' standards. A taste disorder was found in 46% of the IFP and 31% of the BFP cases (not significant). About one-third of the BFP patients complained of radicular or back pain. We conclude that a history of taste disorder is not helpful in distinguishing clinically between BFP and IFP.
Asunto(s)
Borrelia burgdorferi , Parálisis Facial/etiología , Enfermedad de Lyme/complicaciones , Enfermedad de Lyme/diagnóstico , Trastornos del Gusto/epidemiología , Anticuerpos Antibacterianos , Dolor de Espalda/diagnóstico , Estudios de Cohortes , Diagnóstico Diferencial , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/diagnóstico , Cefalea/diagnóstico , Humanos , Leucocitosis/líquido cefalorraquídeo , Leucocitosis/diagnóstico , Leucocitosis/epidemiología , Enfermedad de Lyme/líquido cefalorraquídeo , Persona de Mediana Edad , Dolor/diagnóstico , Prevalencia , Estudios Retrospectivos , Punción Espinal , Trastornos del Gusto/líquido cefalorraquídeo , Trastornos del Gusto/diagnósticoRESUMEN
CONCLUSIONS: Finding human herpesvirus (HHV)-7 and dual HHV-6A and -6B DNA in cerebrospinal fluid (CSF) of two facial palsy (FP) patients is intriguing but does not allow etiologic conclusions as such. HHV-6 or -7 DNA was revealed in 10% of the CSF samples tested from 70 immunocompetent adolescents and adults; a highly unusual result. How these findings are associated with the diseases they accompany remains to be defined. OBJECTIVE: To determine whether herpes simplex virus (HSV)-1 and -2, varicella-zoster virus (VZV), HHV-6A, -6B, and -7, Epstein-Barr virus (EBV), and cytomegalovirus (CMV) DNA could be found in CSF of FP patients or controls. SUBJECTS AND METHODS: In all, 33 peripheral FP patients (26 idiopathic, 5 with herpesvirus infection, 1 puerperal, 1 Melkersson-Rosenthal syndrome) (34 CSF samples) and 36 controls (16 nonidiopathic FP, 7 hearing loss, 6 vertigo, 5 headache, 2 other) previously tested for HSV-1, VZV, and HHV-6 DNA by polymerase chain reaction (PCR) were tested with highly sensitive multiplex-PCR and an oligonucleotide microarray method. RESULTS: One FP patient had HHV-7 DNA and another had HHV-6A and -6B DNA simultaneously. In the control group, one HHV-7, one HHV-6A, and three HHV-6B DNA-positive specimens were found.
Asunto(s)
ADN Viral/líquido cefalorraquídeo , Parálisis Facial/líquido cefalorraquídeo , Herpesvirus Humano 6/genética , Herpesvirus Humano 7/genética , Infecciones por Roseolovirus/líquido cefalorraquídeo , Adolescente , Adulto , Anciano , Niño , Preescolar , Parálisis Facial/etiología , Parálisis Facial/virología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Análisis por Micromatrices , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Estudios Retrospectivos , Infecciones por Roseolovirus/complicaciones , Infecciones por Roseolovirus/virologíaRESUMEN
Juvenile myelomonocytic leukemia (JMML) is a distinct myeloproliferative malignancy of early childhood with a varied clinical presentation that may include failure to thrive, malaise, fever, bleeding, pallor, lymphadenopathy, and hepatosplenomegaly. Skin, pulmonary, and gastrointestinal involvement have also been reported. There are no reports of central nervous system (CNS) involvement at diagnosis of this disease. This is a report of a 21-month old boy who had a right facial paresis at presentation. A brain mass was demonstrated on magnetic resonance imaging and cerebrospinal fluid analysis confirmed CNS leukemic infiltration. We report the presence of CNS infiltration as a part of the natural course of JMML and provide a review of the literature.
Asunto(s)
Parálisis Facial/diagnóstico , Leucemia Mielomonocítica Juvenil/diagnóstico , Encéfalo/patología , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/etiología , Humanos , Lactante , Leucemia Mielomonocítica Juvenil/líquido cefalorraquídeo , Leucemia Mielomonocítica Juvenil/complicaciones , Infiltración Leucémica/patología , Imagen por Resonancia Magnética , MasculinoRESUMEN
BACKGROUND: The etiology of facial paresis (FP) often remains unresolved. Yet, a microbial association is frequently suspected. OBJECTIVE: To evaluate the infectious etiology of FP by using sensitive tests. STUDY DESIGN: We studied the serum and cerebrospinal fluid of 42 patients diagnosed with idiopathic peripheral facial paresis using sensitive serological methods and nucleic acid detection and for reference, 42 patients with other neurological disorders (OND) matched for age, sex, season and geographical area. RESULTS: Varicella zoster virus and Borrelia burgdorferi accounted for 56% of all associated agents in children with FP compared with 11% of OND (P=0.01). In adults, the respective numbers were 29 and 13%. Other treatable etiological agents, Chlamydia pneumoniae and Mycoplasma pneumoniae, accounted for 11% in children and 8% in adults and with the same prevalence between patients with FP and OND. CONCLUSIONS: Microbes, with specific therapy available accounted for 52% of all associated agents in the patients with FP when compared with 26% in controls with OND (P=0.04). Based on this, we conclude that the patients with FP may benefit from antimicrobial therapy.
Asunto(s)
Borrelia burgdorferi/aislamiento & purificación , Parálisis Facial/microbiología , Herpesvirus Humano 3/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/líquido cefalorraquídeo , Borrelia burgdorferi/inmunología , Niño , Preescolar , Chlamydophila pneumoniae/inmunología , Chlamydophila pneumoniae/aislamiento & purificación , ADN Viral/líquido cefalorraquídeo , Parálisis Facial/sangre , Parálisis Facial/líquido cefalorraquídeo , Femenino , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/inmunología , Humanos , Masculino , Persona de Mediana Edad , Mycoplasma pneumoniae/inmunología , Mycoplasma pneumoniae/aislamiento & purificaciónRESUMEN
Neurological complications represent one of the most important causes of morbidity and mortality in patients with HIV/AIDS. However, peripheral neuropathy comprises only 5% to 20% of the total neurological complications and facial nerve palsy, especially when it is bilateral, is a less common manifestation. Peripheral facial palsy has been considered as a possible neurological complication of the early stage of HIV infection but the number of reported cases in the literature is limited. Histological findings of nervous tissue in peripheral facial palsy at an early stage of HIV infection include a degenerative and not suppurative inflammatory process, but its etiology remains obscure. Peripheral facial palsy in the late stage of HIV infection is characterized by an advanced immunological deficit and generally it is secondary to an opportunistic infection of the CNS, such as neurotoxoplasmosis and lymphoma. However, this peripheral attack of the facial nerve is not very common at this late stage of HIV infection. Bilateral peripheral facial palsy as a complication of non-Hodgkin s lymphoma is considered an extremely rare entity. There are no published reports of bilateral peripheral facial palsy secondary to lymphomas or other neoplasms of the CNS in immunosuppressed patients. Non-Hodgkin s lymphoma (NHL) has been considered a late and relatively common manifestation of HIV infection, but an exact cause for the higher incidence of this malignant neoplasm in HIV/AIDS patients is still uncertain.
Asunto(s)
Parálisis Facial/complicaciones , Parálisis Facial/etiología , Infecciones por VIH/complicaciones , Linfoma no Hodgkin/complicaciones , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ciclofosfamida/uso terapéutico , Doxorrubicina/uso terapéutico , Parálisis Facial/líquido cefalorraquídeo , Infecciones por VIH/líquido cefalorraquídeo , Humanos , Linfoma no Hodgkin/líquido cefalorraquídeo , Linfoma no Hodgkin/tratamiento farmacológico , Masculino , Prednisona/uso terapéutico , Vincristina/uso terapéuticoRESUMEN
Cerebrospinal fluid (CSF) is rarely analyzed in peripheral facial palsy, and reports in the literature are scarce. We report the CSF findings in 265 patients with acute isolated peripheral facial palsy. The CSF findings were abnormal in 11% of 230 patients with idiopathic peripheral facial palsy, in 60% of 17 patients with Ramsay Hunt syndrome (pleocytosis), in 25% of 8 patients with Lyme disease, in all of 8 patients with HIV infection, and in 2 other patients (sarcoidosis and herpes simplex). We conclude from this large series that the CSF is usually normal in idiopathic peripheral facial palsy. If the CSF is abnormal, a specific cause should be sought.
Asunto(s)
Parálisis Facial/líquido cefalorraquídeo , Adolescente , Adulto , Anciano , Parálisis Facial/diagnóstico , Femenino , Infecciones por VIH/líquido cefalorraquídeo , Infecciones por VIH/complicaciones , Humanos , Enfermedad de Lyme/líquido cefalorraquídeo , Enfermedad de Lyme/complicaciones , Enfermedad de Lyme/diagnóstico , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/líquido cefalorraquídeo , Enfermedad de Parkinson/diagnóstico , Estudios RetrospectivosRESUMEN
Two cases of bilateral facial palsy after hymenoptera sting are presented. In both cases, the neurological examination is otherwise normal, a lymphoplasmocytic reaction is present in the CSF, no other etiology is found, and the recovery is complete. The neurological complications of hymenoptera sting and the differential diagnosis of bilateral facial palsy are discussed.
Asunto(s)
Parálisis Facial/etiología , Himenópteros , Mordeduras y Picaduras de Insectos/complicaciones , Adulto , Animales , Niño , Diagnóstico Diferencial , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/diagnóstico , Humanos , MasculinoRESUMEN
Listeria monocytogenes rhomboencephalitis is an uncommon complication of L. monocytogenes meningitis. It presents in a typical biphasic pattern characterized by a non-specific prodromal period followed by any combination of asymmetrical, cranial-nerve palsies; cerebellar signs; hemiparesis or hypesthesia; and diminished consciousness. The survival rate is greater than 70% when appropriate antibiotic therapy is initiated early. However, approximately 60 percent of the survivors develop neurological sequelae. We present the case of a 33-year-old woman who developed L. monocytogenes meningitis with subsequent rhomboencephalitis and cranial-nerve palsie, and review the literature on this syndrome.
Asunto(s)
Encefalitis/microbiología , Parálisis Facial/microbiología , Listeria monocytogenes/aislamiento & purificación , Listeriosis/microbiología , Enfermedades del Nervio Oculomotor/microbiología , Rombencéfalo , Adulto , Ampicilina/uso terapéutico , Encefalitis/líquido cefalorraquídeo , Encefalitis/tratamiento farmacológico , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Listeriosis/líquido cefalorraquídeo , Listeriosis/tratamiento farmacológico , Meningitis Bacterianas/líquido cefalorraquídeo , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/microbiología , Enfermedades del Nervio Oculomotor/líquido cefalorraquídeo , Enfermedades del Nervio Oculomotor/tratamiento farmacológico , Penicilinas/uso terapéuticoRESUMEN
Our objective was to determine the diagnostic value of CSF examinations in the diagnosis of neuroborreliosis in children with peripheral facial palsy (PFP). Paired serum and CSF samples from 21 children with PFP were investigated for antibody responses to Borrelia burgdorferi antigens using three different ELISA systems and one Western blot assay. Twenty of the children (95%) had detectable immunoglobin (Ig) M or IgG in the acute-phase serum, but discrepancies between serologic assays were noted in 33% for IgM and 22 to 50% for IgG. Intrathecal specific-antibody production was detected in five of the 20 seropositive children (25%). These five patients showed seroconversion in convalescent sera in at least one assay. Similar seroconversion suggesting recent infection with B. burgdorferi was observed in eight of the 10 children (80%) without intrathecal specific-antibody production, from whom convalescent serum samples could be obtained. All patients with intrathecal antibodies or seroconversion had shown lymphocytic pleocytosis in the acute phase of PFP. In the acute phase of PFP the detection of intrathecal production of antibodies to B. burgdorferi allows prompt diagnosis of neuroborreliosis. For patients with lymphocytic pleocytosis but no detectable intrathecal antibodies, analysis of convalescent serum may help to establish this diagnosis.
Asunto(s)
Anticuerpos Antibacterianos/líquido cefalorraquídeo , Grupo Borrelia Burgdorferi/inmunología , Parálisis Facial/líquido cefalorraquídeo , Parálisis Facial/inmunología , Enfermedad de Lyme/líquido cefalorraquídeo , Enfermedad de Lyme/inmunología , Adolescente , Anticuerpos Antibacterianos/análisis , Western Blotting , Recuento de Células , Líquido Cefalorraquídeo/citología , Proteínas del Líquido Cefalorraquídeo/análisis , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Parálisis Facial/sangre , Femenino , Humanos , Inmunoglobulina G/líquido cefalorraquídeo , Inmunoglobulina M/líquido cefalorraquídeo , Enfermedad de Lyme/sangre , MasculinoRESUMEN
UNLABELLED: Neuroborreliosis occasionally represents a diagnostic problem, especially in the early stage of the infection. The polymerase chain reaction (PCR) offers an attractive alternative to antibody testing. The aim of our study was to investigate the diagnostic potential of PCR in comparison to antibody tests in CSF of children with facial palsy. In contrast to other manifestations of neuroborreliosis, facial palsy is a well-defined clinical entity in which CSF findings allow an early distinction according to aetiology. The study included 17 children with neuroborreliosis, defined by the detection of specific IgM antibodies in CSF, and 20 children with facial palsy of unknown cause. Primers used for the nested PCR were generated from conserved sequences of the OspA-gene. Most of the cases in both subgroups have been examined within a few days after the onset of the paresis. Only in 2 out of 17 cases with neuroborreliosis could specific DNA be amplified. The PCR gave negative results in all cases of the control group. CONCLUSION: The IgM capture ELISA is superior to PCR to support the clinical diagnosis of neuroborreliosis.
Asunto(s)
Infecciones por Borrelia/diagnóstico , Grupo Borrelia Burgdorferi/aislamiento & purificación , Parálisis Facial/microbiología , Reacción en Cadena de la Polimerasa/métodos , Enfermedad Aguda , Adolescente , Anticuerpos Antibacterianos/líquido cefalorraquídeo , Secuencia de Bases , Infecciones por Borrelia/líquido cefalorraquídeo , Estudios de Casos y Controles , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Parálisis Facial/líquido cefalorraquídeo , Femenino , Humanos , Inmunoglobulina G/líquido cefalorraquídeo , Inmunoglobulina M/líquido cefalorraquídeo , Enfermedad de Lyme/líquido cefalorraquídeo , Enfermedad de Lyme/microbiología , Masculino , Datos de Secuencia MolecularRESUMEN
Human immunodeficiency virus infection frequently involves the peripheral or central nervous system. Seven cases of isolated peripheral facial palsy that occurred at various stages of the disease are reported. The palsy was the first manifestation of the disease in 5 patients, and revealed it in 3 of them. The palsy involved the right side in 6 cases (complete N = 2; incomplete N = 4); it was bilateral in one (complete on both sides). Abnormalities of the cerebrospinal fluid were present in all patients but differed depending on the stage of the retroviral infection. Electroneuromyography defined the type of the palsy, principally due to axonotmesis in 4 patients (including the bilateral one) and principally to neurapraxia in 3 patients. The outcome was good in most cases. The physiopathology remains undetermined.