Ann Clin Neurophysiol.  2019 Jul;21(2):98-101. 10.14253/acn.2019.21.2.98.

Facial diplegia as a delayed complication of scrub typhus

• Baek JG
• Hong HL
• Park JH

• KMID: 2454731
• DOI: http://doi.org/10.14253/acn.2019.21.2.98

Abstract

A 64-year-old man presented with facial diplegia occurring 2 weeks after scrub typhus diagnosis. The serum scrub typhus antibody titer was elevated to 1:5120. Brain magnetic resonance imaging revealed contrast-enhancement of the signal for both facial nerves. He was administered prednisolone. After two weeks, the symptoms improved, and after one month, he completely recovered from facial diplegia. This is the first case in the literature in which the patient exhibited facial diplegia, a delayed complication, in scrub typhus. Facial diplegia should be considered a type of cranial nerve palsy that may occur as a delayed complication of scrub typhus.

Keyword

Facial palsy; Facial neuritis; Scrub typhus

MeSH Terms

Brain
Cranial Nerve Diseases
Diagnosis
Facial Nerve
Facial Nerve Diseases
Facial Paralysis
Humans
Magnetic Resonance Imaging
Middle Aged
Prednisolone
Scrub Typhus*
Prednisolone

Figure

• 

  Fig. 1 Magnetic resonance imaging findings of the patient. Axial (A) and coronal (B, C) T1-weighted images showed gadolinium enhancement of the bilateral facial nerve genu (arrows).

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  Fig. 2 The results of blink reflex test. Blink reflex showed poor wave formation for both stimulation of both facial nerves. Prolonged ipsilateral R1 response, but normal bilateral R2 response, were observed with right nerve stimulation (A). Left nerve stimulation showed a delay in the R1 and bilateral R2 responses (B).

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