Mumps

Mumps is caused by infection with an RNA paramyxovirus. The most common presentation is parotid gland swelling and pain; the testicles, pancreas, kidneys, eyes, and ovaries are also often involved. As mumps has a predilection for neural tissue, neurologic involvement is present in 5% to 30% of cases and may manifest as meningitis, encephalitis, or cranial neuropathies (14). Among cranial nerve involvement, the facial and cochleovestibular nerves are most commonly affected. Some investigators report facial paralysis as a rare sequelae of mumps (15) while others report a higher incidence, as high as 15% (14).

The pathogenesis of neural involvement has not been investigated in the literature. It remains unclear whether facial nerve involvement is related to parotitis, aseptic meningitis, direct viral injury, or swelling along the intracanalicular course of the nerve (14).

Diagnosis is made clinically and can be confirmed with serologic titers. Up to 30% of cases demonstrate lymphocytosis of the CSF, but this is a nonspecific finding (14). Treatment remains symptomatic for this viral infection. Prevention using mumps vaccinations remains the most effective measure for control. Since the introduction of vaccination against the virus, there has been a dramatic decrease in the incidence of infection. Facial paralysis in mumps appears to have a poor prognosis, with a small review of the literature showing only 25% of patients with complete recovery (16).

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