J Neurol Neurosurg Psychiatry 81:1155-1156 doi:10.1136/jnnp.2009.195313
  • Neurological picture

Bilateral facial nerve palsy associated with Epstein–Barr virus infection

  1. T C Andrews1
  1. 1Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Thomasin C Andrews, Department of Neurology, 3rd Floor, Lambeth Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK; thomasin.andrews{at}
  • Accepted 16 October 2010
  • Published Online First 22 June 2010

Case report

A previously well 33-year-old man was admitted to hospital with a 2-week history of intermittent fever and inguinal lymphadenopathy and a 2-day history of jaundice. Acute hepatitis due to Epstein–Barr virus (EBV) infection was diagnosed based on a positive Paul–Bunnell test result and EBV immunoglobulins G and M and exclusion of other causes (see supplementary data). He was managed conservatively and discharged home after 2 weeks.

Three days after discharge, he developed left-sided facial weakness. He was seen in the medical outpatient clinic and found to have a left-sided facial nerve paresis. He was referred to the hospital 4 days later with worsening facial weakness. On examination, there was bilateral facial nerve paresis, worse on the left than the …

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