Reactivation of varicella-zoster virus in delayed facial palsy after dental treatment and oro-facial surgery

In rare cases, acute peripheral facial palsy occurs several days after dental treatment and orofacial surgery. Surgical procedures have been known to trigger reactivation of varicella-zoster virus (VZV) and herpes simplex virus type 1 (HSV-1). The present study examined eight patients who exhibited delayed facial palsy after dental treatment or ore-facial surgery. Ramsay Hunt syndrome was diagnosed in three patients and varicella-zoster virus (VZV) reactivation without tester lesions (zoster sine herpete) was diagnosed in three patients either by PCR or serological assay. Therefore, VZV reactivation was detected in 75% (6 of 8) of patients who exhibited delayed facial palsy after dental or orofacial treatment. The results suggest that VZV reactivation is a major cause of delayed facial palsy after dental treatment or ore-facial surgery. J. Med. Virol. 62:42-45, 2000. (C) 2000 Wiley-Liss, Inc.