Only a handful of reports are present in the world literature stating the association of hepatitis A with Bell’s palsy, with majority of them being unilateral.[1-3] A recent review on the prevalence of serological markers of hepatitis, cytomegalovirus and rubella in patients with Bell’s palsy revealed a serological positivity for hepatitis B in 15 out of 21 patients (71%) as against 32.1% positivity in the control group. No relation was noted in the above study with hepatitis A serological positivity. Neurological complications during the acute and convalescent phase of acute HAV infection have been reported in the form of aseptic meningitis, cranial neuropathies (trigeminal, facial, vestibulocochlear) and visual disturbances. However, bilateral facial nerve palsies associated with recent acute HAV infection has not been reported so far. The purpose of this letter is to make health care professionals more aware of facial palsy complication of hepatitis A infection. Even though a rare association, the common viral tests for facial palsy could include hepatitis viruses especially, if there is past history suggestive of acute hepatitis.
For correspondence: Dr. Sudhir Sharma, Department of Neurology,
Indira Gandhi Medical College, Shimla - 171 001, Himachal Pradesh, India E-mail: [email protected]
Swaroop A, Parihar N, Jain S. Bell’s palsy — A rare association with hepatitis A. J Indian Acad Clin Med 2008;9:51-2. 2. Thapa R, Mallick D, Biswas B, Ghosh A. Childhood hepatitis A virus infection complicated by Bell’s palsy. Clin Pediatr (Phila) 2009;48:427-8. 3. Yildiz B, Yakut A, Bor O, Yarar C. Bell’s palsy and hepatitis infection. Pediatr Int 2006;48:493-4. 4. Unlu Z, Aslan A, Ozbakkaloglu B, Tunger O, Surucuoglu S. Serological examinations of hepatitis, cytomegalovirus and rubella in patients with Bell’s palsy. Am J Phys Med Rehabil 2003;82: 28-32. Access this article online Quick Response Code:
Departments of Neurology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, 1Postgraduate Institute of Medical Education & Research, Chandigarh, India
Racemose neurocysticercosis and reversible dementia Sir, The recent publication on racemose neurocysticercosis (NCC) and reversible dementia is very interesting. Sharma et al. reported that “The outcome of dementia patients with NCC seems favorable in most cases; therefore, a high index of suspicion for NCC should be kept, especially in endemic areas.” Indeed, the neurological symptom is not rate in NCC. Indeed, the existing of dementia and cognitive function impairment in NCC is more common in non-calcified active NCC.  Nearly, 40% of all non-calcified active NCC can present with dementia. In the real life, dementia might be lately detected and clinical work-up does usually not include looking for NCC. Focusing on the outcome; although, the present report showed favorable outcome. Some previous reports mentioned for discordant observation after complete treatment.
For correspondence: Mrs. Somsri Wiwanitkit, Wiwanitkit House,
Sharma S, Modi M, Lal V, Prabhakar S, Bhardwaj A, Sehgal R. Reversible dementia as a presenting manifestation of racemose neurocysticercosis. Ann Indian Acad Neurol 2013;16:88-90. 2. Rodrigues CL, de Andrade DC, Livramento JA, Machado LR, Abraham R, Massaroppe L, et al. Spectrum of cognitive impairment in neurocysticercosis: Differences according to disease phase. Neurology 2012;78:861-6. 3. Ciampi de Andrade D, Rodrigues CL, Abraham R, Castro LH, Livramento JA, Machado LR, et al. Cognitive impairment and dementia in neurocysticercosis: A cross-sectional controlled study. Neurology 2010;74:1288-95. Access this article online
Somsri Wiwanitkit, Viroj Wiwanitkit1,2,3
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Wiwanitkit House, Bangkhae, Bangkok, Thailand, 1Hainan Medical University, China, 2 Faculty of Medicine, University of Nis, Serbia, 3 Joseph Ayobabalola University, Nigeria Annals of Indian Academy of Neurology, October-December 2013, Vol 16, Issue 4
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