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To the Editor.—An observation only briefly discussed in the recent article "Acute Peripheral Facial Palsy" by Stien and Tonning (Arch Otolaryngol 98:187, 1973) was of great interest. The authors mentioned that one of their 46 patients had a positive Paul-Bunnell (heterophil) reaction on initial laboratory evaluation. We recently described three patients (ages, 24, 26, and 27 years) with unilateral peripheral facial palsy who had hematologic and serologic evidence of infectious mononucleosis (Lancet 2:231, 1973). One of the three patients developed a clinical mononucleosis syndrome several weeks after the onset of the facial paralysis. Because of the variable sequence of symptoms and signs, we suggest that a second or third heterophil and differential white blood cell count during the course of facial palsy should uncover more instances of this association with infectious mononucleosis.
GROSE C. Facial Palsy and Infectious Mononucleosis. Arch Otolaryngol. 1974;99(4):309. doi:10.1001/archotol.1974.00780030319018
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