Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle

Ann Intern Med. 1996 Jan 1;124(1 Pt 1):27-30. doi: 10.7326/0003-4819-124-1_part_1-199601010-00005.


Objective: To determine whether herpes simplex virus type 1 (HSV-1) causes Bell palsy.

Design: Prospective study.

Setting: University inpatient service.

Patients: 14 patients with Bell palsy, 9 patients with the Ramsay-Hunt syndrome, and 12 other controls.

Measurements: Viral genomes of HSV-1, varicella-zoster virus, and Epstein-Barr virus were analyzed in clinical samples of facial nerve endoneurial fluid and posterior auricular muscle using polymerase chain reaction (PCR) followed by hybridization with Southern blot analysis.

Results: Herpes simplex virus type 1 genomes were detected in 11 of 14 patients (79%) with Bell palsy but not in patients with the Ramsay-Hunt syndrome or in other controls. The nucleotide sequences of the PCR fragments were identical to those of the HSV-1 genome.

Conclusions: Herpes simplex virus type 1 is the major etiologic agent in Bell palsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Base Sequence
  • Blotting, Southern
  • Body Fluids / virology*
  • Child
  • Child, Preschool
  • DNA, Viral / isolation & purification*
  • Facial Paralysis / virology*
  • Female
  • Genome, Viral
  • Herpes Zoster Oticus / physiopathology
  • Herpes Zoster Oticus / virology
  • Herpesvirus 1, Human* / genetics
  • Humans
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Muscle, Skeletal / virology*
  • Polymerase Chain Reaction
  • Prospective Studies


  • DNA, Viral