Intrathecal synthesis of specific antibodies in facial nervepalsy

According to literature at least part of idiopathic facial nerve palsies is caused by herpetic viruses for example varicella zoster virus in ramsay -Hunt syndrome. The aim of our study was to detect intrathecal synthesis of specific IgG antibodies against varicella zoster virus in patients with idiopathic facial nerve palsy and to evaluate the importance of this examination for establishing the etiology of this disease and subsequent treatment. Methods: We investigated a cohort of 30 patients :15 patients were diagnosed as idiopathic facial nerve palsy and 15 patients were diagnosed as neuroborreliosis (NB) with facial nerve palsy as a part of their clinical symptoms. Serum and CSF samples were analysed at each patient. We used the diagnostic kit of Human Company ,Germany (Varicella -Zoster Virus Human ELISA IgG Antibody Test) and the diagnostic kit of Test -Line Company .Clinical Diagnostics ,Czech Republic (EIA Borrelia garinii IgG)for the detection of specific IgG antibodies. The intrathecal synthesis was evaluated as specific antibody index -AI according to Reiberś method. Results: Intrathecal synthesis of IgG antibodies against varicalla zoster virus was detected in 20% patients with idiopathic facial nerve palsy. All these patients had negative intrathecal anti - borrelia antibody synthesis. In the NB subgroup all patients had negative intrathecal antibody synthesis against varicella zoster virus. The statistical significance of specific antibody intrathecal synthesis was confirmed by Spearman rank coefficient and Wilcoxon test. Conclusion : Our statistically supported data emphasize the importance of intrathecal synthesis of specific antibodies as a diagnostic method in patients with idiopathic facial nerve palsy. It reveals a subgroup of patients with viral ethiology who can thus profit from specific antiviral treatment.