Increased seroprevalence of Toxoplasma gondii in a population of patients with Bell's palsy: a sceptical interpretation of the results regarding the pathogenesis of facial nerve palsy.

Facial nerve oedema and anatomical predisposition to compression within the fallopian tube seem to be the only generally accepted facts in the pathophysiology of Bell's palsy. Several infectious causes have been suggested as possible triggers of this oedema. Most of the suggested pathogens have been associated with facial nerve lesions during latent infections, reinfections or endogenous reactivations. The aim of this study was to investigate the seroprevalence of three such pathogens Toxoplasma gondii, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in a population of patients with facial nerve palsy. Fifty-six patients with Bell's palsy were included in the study. A group of 25 individuals with similar age and gender distribution was used as control. Seropositivity for T. gondii, EBV viral capsid antigen (VCA) and CMV-specific IgM and IgG antibodies was investigated 2-5 days after the onset of the palsy. Comparisons for both IgM and IgG antibodies against T. gondii attributed significantly higher seroprevalence in the patients' group than in the control group (p = 0.024 and 0.013, respectively). The respective examinations for EBV and CMV attributed no significant results. The roles of EBV and CMV in the pathogenesis of Bell's palsy were not confirmed by this study. However, a significantly higher seroprevalence of IgM- and IgG-specific T. gondii antibodies was detected in patients with Bell's palsy when compared to healthy controls. The possibility that facial nerve palsy might be a late complication of acquired toxoplasmosis may need to be addressed in further studies.

Evaluation of the acoustic function in pseudoexfoliation syndrome and exfoliation glaucoma: audiometric and tympanometric findings.

PURPOSE: Previous studies have reported increased audiometric thresholds in patients with pseudoexfoliation syndrome (XFS), compared with normative data. This study examines mean audiometric thresholds and tympanometric peak values in patients with XFS and in a control group. METHODS: This is a prospective, nonrandomized control case study. Patients with XFS in one or both eyes constituted the study group (SG). Patients without XFS in either eye constituted the control group (CG). Patients with a history of conditions affecting hearing function were excluded. The SG and the CG included 54 and 48 patients, respectively. Pure tone hearing thresholds levels were measured at 0.25, 1, 2, 3, and 8 kHz. Tympanometric peak values were also recorded. Differences in audiometric mean threshold values and tympanometric peak values between SG and CG, as well as between glaucomatous and nonglaucomatous eyes, were examined. RESULTS: Bone and air audiometric thresholds were significantly increased in SG for 3 kHz and 8 kHz but not for 0.25 kHz, 1 kHz, and 2 kHz. Tympanometric peak values were significantly lower in SG compared with CG. In SG, glaucomatous patients had significantly higher air-conduction thresholds for 3 kHz and 8 kHz. Differences in bone and air audiometric findings as well as tympanometric findings between glaucomatous and nonglaucomatous patients were statistically not significant in CG. CONCLUSIONS: The results agree with previous reports on sensorineural hearing loss in XFS. The reduced tympanometric peak values in SG imply impairment in the elastic properties of the middle ear in XFS. The findings provide additional evidence for the systemic nature of XFS.