Facial paresis: a worrying event related to labial herpes simplex and periocular botulinum toxin a injection
Main Article Content
Keywords
Botulinum toxin, Herpes simplex virus, facial palsy
Abstract
The Authors report on a case of facial paresis following reactivation of labial Herpes simplex in a 59 years woman treated with sequential periocular BoNTA injection and blepharoplasty. A mild palsy occurred on the whole right hemiface 12 days after upper blepharoplasty, 22 days after BoNTA injection (40 U) in the periorbital area and in the glabella.
The patient was treated with Acyclovir for 5 days and with oral B complex vitamins for 12 weeks. The symptoms slowly recovered in 4 months.
Facial paresis might have been simply triggered by an invasive treatment related inflammatory reaction. Nevertheless, the Herpes virus might have promoted the anterograde diffusion of the toxin, previously migrated from the site of injection to the facial nucleus through a retrograde pathway.
The Authors suggest Acyclovir prophylaxis in patients affected by recent or recurrent forms of Herpes simplex infection when planning BoNTA injection in the face.
References
2. Theil D, Horn AKE, Derfuss T, Strupp M, Arbusow V, Brandt T. Prevalence and distribution of HSV-1, VZV, and HHV-6 in human cranial nerve nuclei III, IV, VI, VII, and XII. The Journal of Neuroscience 2008, 28(14):3689 –3696.
3. Freire de Castro R, Crema D, Neiva FC, Pinto RASR, Suzuki FA. Prevalence of herpes zoster virus reactivation in patients diagnosed with Bell's palsy. J Laryngol Otol
2022 Oct; 136(10):975-978.
4. Kennedy PG. Herpes simplex virus type 1 and Bell's palsy-a current assessment of the controversy. J Neurovirol 2010 Feb;16(1):1-5.
5. Mandrini S, Comelli M, Dall’Angelo A, Togni R, Cecini M, Pavese C, Dalla Toffola E.
Long-term facial improvement after repeated BoNT-A injections and mirror biofeedback
exercises for chronic facial synkinesis: a case-series study. Eur J Phys Rehabil Med
2016 ; 52(6):810-818.
6. Ramappa M, Jiya PY, Chaurasia S, Naik M, Sharma S. Reactivation of herpes simplex viral keratitis following the botulinum toxin injection. Indian J Ophthalmol 2018;66:306-8.
7. Das N, Das J, Basak S. A Case of Reactivation of Herpes Simplex Virus Corneal Endotheliitis Following Periocular Botulinum Toxin A Injection. Ophthalmic Plast Reconstr Surg 2020 May/Jun;36(3):e73-e75.
8. Gilbert E, Zhu J, Peng T, Ward NL. Decreased labial herpes simplex virus outbreaks following Botulinum neurotoxin type A Injection: A Case Report. J Drugs Dermatol 2018 Oct 1;17(10):1127-1129.
9. Caleo M, Spinelli M, Colosimo F, Matak I, Rossetto O,Lackovic Z, Restani L. Transynaptic Action of Botulinum Neurotoxin Type A at Central Cholinergic Boutons. J Neurosci. 2018 Nov 28;38(48):10329-10337. doi: 10.1523/JNEUROSCI.0294-18.2018.
10. Antonucci F, Rossi C, Gianfranceschi L, Rossetto O, Caleo M. Long-Distance Retrograde Effects of Botulinum Neurotoxin A. J Neurosci. 2008 Apr 2;28(14):3689-96. doi: 10.1523/JNEUROSCI.0375-08.2008.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
