Bilateral facial palsy in an adult with chickenpox


  • Arthur Wong Department of Otorhinolaryngology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  • Jeyanthi Kulasegarah Department of Otorhinolaryngology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia



Varicella, Chickenpox, Facial palsy


Chickenpox is a result of primary infection with varicella zoster virus. Isolated facial nerve palsy as a complication is rare, and here we report an extraordinary case of bilateral facial nerve palsy following chickenpox in an adult. A 55-year-old male presented to the emergency department with a day’s history of facial weakness. He had recently contracted chickenpox with an onset 16 days prior. Physical examination noted crusted vesicles all over the body and a bilateral facial palsy. There were no clinical signs of meningitis or cerebrovascular accident. He was managed with a short course of oral aciclovir and prednisolone and recovered fully after a month. Presentations of facial nerve palsy in chickenpox are rare and should be differentiated from Ramsay Hunt syndrome. Prognosis is relatively good with the majority of known cases seeing complete facial nerve recovery within 6 months.  


Blair RJ. Varicella Zoster Virus. Pediatr Rev. 2019;40(7):375-7.

Oghan F, Topuz MF, Erdogan O. Facial Paralysis During Varicella Zoster Infection in a child. Heighpubs Otolaryngol Rhinol. 2017;1:16-9.

Ferreira H, Dias Â, Lopes A. Acute Peripheral Facial Palsy after Chickenpox: A Rare Association. Case Rep Pediatr. 2014.

Muñoz-Sellart M, García-Vidal C, Martínez-Yelamos S, Niubó J, Fernández-Viladrich P. Peripheral facial palsy after varicella. Report of two cases and review of the literature. Enferm Infecc Microbiol Clin. 2010;28(8):504-8.

Rao GRR, Amareswar A, Kumar YHK, Rani R. Isolated facial palsy in varicella (Letters to the Editor). Ind J Dermatol Venereol Leprol. 2008;74(3):261-2.

Tunbridge AJ, Breuer J, Jeffery KJM. Chickenpox in adults - Clinical management. J Infect. 2008;57(2):95-102.

Gnann JW Jr. Varicella-zoster virus: a typical presentations and unusual complications. J Infect. Dis 2002;186:91-8.

Jeon Y, Lee H. Ramsay Hunt syndrome. J Dent Anesth Pain Med. 2018;18(6):333-7.

Robillard RB, Hilsinger RL Jr, Adour KK. Ramsay Hunt facial paralysis: clinical analyses of 185 patients. Otolaryngol Head Neck Surg. 1986;95:292-7.






Case Reports