The association between herpes simplex virus-1 (HSV-1) infection and Bell palsy was determined in 47 children studied at Children's Hospital at Montefiore, Bronx, NY. Swabs of saliva and conjunctiva were taken for PCR testing. To validate PCR testing, swabs were obtained from patients with oral lesions of herpes gingivostomatitis. An HSV-1 enzyme-linked immunosorbent assay was positive in 33 of 42 affected patients compared to 16 of 41 controls (P=0.0003). HSV-1 polymerase chain reaction was positive in 10 of 47 affected patients compared to 4 of 45 controls (P=0.08). The findings support an association between HSV-1 infection and Bell palsy in children. 
COMMENT. These findings in children confirm previous reports of a probable role for HSV-1 infection in adults with Bell's palsy. Acyclovir in treatment of Bell's palsy deserves further study. Other infectious causes reported include Epstein-Barr virus, mumps, enteroviruses, and rarely, varicella zoster virus (geniculate herpes, Ramsay Hunt syndrome).