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- 奥野 仁
- 日本大学医学部耳鼻咽喉科学教室
書誌事項
- タイトル別名
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- Early diagnosis of varicella-zoster virus infection in acute facial paralysis. Significance of VZV antigen skin test and CSF examination.
- SIGNIFICANCE OF VZV ANTIGEN SKIN TEST AND CSF EXAMINATION
- 皮内反応と髄液検査の意義
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抄録
In the early stage of acute facial paralysis, proving the presence of a viral infection has important therapeutic as well as prognostic implications.<br>We have already known that a significant increase of serum complement fixation (CF) antibody titer of the varicella-zoster virus (VZV) appears in 20 to 30% of Bell's palsy cases. However, it is difficult to say that the most common method of diagnosing a viral infection, by measuring the amount of serum CF antibody titer, is rapid, bacause it takes more than 2 or 3 weeks to reach a final conclusion. Recently, Takahashi6) reported a new procedure for diagnosing VZZ infection by using a skin test with VZV antigen. This procedure may permit us to succeed in the early diagnosis of a VZV infection. On the other hand, we know that Hunt's syndrome has some influence on the cerebrospinal fluid (CSF), especially in the early stage of the disease. We studied<br>100 patients with acute peripheral facial paralysis by using both the VZV antigen skin test and the examination of the CSF, within 2 weeks after onset of paralysis. The purpose of this roport is to show the results of these two procedures and to point out their usefulness in the early diagnosis of VZV infection in patients with acute peripheral facial paralysis. The results obtained were as follows.<br>1) By using VZV antigen skin test, the ratios of early diagnosis of VZV infection were shown in each diseases, as 85.4% in Hunt's syndrome, 58.3% in zoster sine herpete and 72.3% in Bell's palsy. It was indicated that this procedure is valuable for early diagnosis of VZV infection in these patients.<br>2) In 73.2% of the patients with Hunt's syndrome and 66.7% of with zoster sine herpete, it was possible to detect increased cell counts (mainly monocyte) in the CSF. This is in marked contrast to Bell's palsy, as only 8.5% of these subjects were noted to have increased cell counts (mainly monocyte). By examining cell counts of CSF, it is possible to diagnose a high incidence of viral infections among facial nerve paralysis.<br>3) By carrying out both of skin test with VZV antigen and CSF examinations, 12 out of 59 patients who had been diagnosed as Bell's palsy in their early stage of paralysis were diagnosed to have VZV infection before significant increase of anti-VZV CF antibody titer were detected in the sera.
収録刊行物
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- 日本耳鼻咽喉科学会会報
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日本耳鼻咽喉科学会会報 91 (7), 1078-1084, 1988
一般社団法人 日本耳鼻咽喉科頭頸部外科学会