Multiple cranial neuropathies after a rash in two patients

Abstract

A previously healthy 31-year-old male presented with acute eft facial weakness and horizontal binocular diplopia on looking o the left. Three weeks prior to that, he had fever, myalgia and a eneralized papulovesicular rash 10 days following exposure to his -month-old son who had similar skin lesions. His constitutional ymptoms and rash resolved completely over 2 weeks. Neuroogical examination revealed complete left facial paralysis with ncomplete eye closure and abduction failure of the left eye with onsequent horizontal diplopia. The reminder of the cranial nerve xamination was normal. There were no skin rashes, meningism r long tract signs. These findings were consistent with acute left ower motor neuron facial and left abducens neuropathies. Craial magnetic resonance imaging (MRI) did not detect abnormal arenchymal, leptomeningeal or ependymal lesions or enhanceent. Cerebrospinal fluid (CSF) examination revealed a white cell ount of 8/mm3 (99% lymphocytes, 1% monocytes) and protein of .56 g/L.