Bilateral lower motor neuron facial nerve palsy due to HIV seroconversion

Abstract

A 34-year-old-woman presented with acute onset of headache and bilateral facial nerve paralysis. On examination bilateral lower motor neuron 7th cranial nerve palsy in keeping with bilateral Bell’s palsy was apparent. Investigations showed aseptic meningitis, with a low CD4 count of 352 cells/μl and an elevated viral load (5 300 counts/ml, log = 3.72), in keeping with acute HIV infection. Bell’s palsy is a known complication of seroconversion – 13 cases have been reported worldwide. To our knowledge this is the first reported case in South Africa.