Download PDF
CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(01): 89
DOI: 10.1590/0004-282X-anp-2020-0222
IMAGES IN NEUROLOGY

Facial paralysis in the acute form of Chagas disease

Paralisia facial na forma aguda da doença de Chagas
Eduardo Sousa DE MELO 
1   Universidade Federal de Pernambuco, Unidade de Neurologia e Neurocirurgia, Departamento de Neuropsiquiatria, Recife PE, Brazil.
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
,
Breno José Alencar Pires BARBOSA 
1   Universidade Federal de Pernambuco, Unidade de Neurologia e Neurocirurgia, Departamento de Neuropsiquiatria, Recife PE, Brazil.
,
Carlos Frederico Leite de Souza LIMA 
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
,
Milena Maria de Morais e SILVA 
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
,
Ana Rosa Melo Correa LIMA 
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
,
Filipe Prohaska BATISTA 
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
,
Demetrius MONTENEGRO 
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
,
Luciana Patrizia Alves de Andrade VALENÇA 
1   Universidade Federal de Pernambuco, Unidade de Neurologia e Neurocirurgia, Departamento de Neuropsiquiatria, Recife PE, Brazil.
2   Universidade de Pernambuco, Hospital Universitário Oswaldo Cruz, Recife PE, Brazil.
› Author Affiliations
› Further Information
Also available at
 
 PDF Download Permissions and Reprints

A 34-year-old woman attended a religious meeting in Pernambuco, Brazil, where an outbreak of acute Chagas disease was reported due to oral contamination. She developed headache, myalgia, edema, and vomiting. Serological tests were positive for Chagas and a blood smear confirmed the presence of T. cruzi ([Figure 1A]). Ten days after starting treatment with benznidazole, right peripheral facial palsy was observed ([Figure 1B]). Brain MRI and CSF analyses were unremarkable. Facial electroneuromyography showed mild axonal neuropathy ([Figure 1C-F]). Thirty days later, she recovered completely without any corticoids. Facial paralysis could be a rare neurological manifestation of Chagas disease[1], a treatment complication[2],[3] or coincidental.

Zoom Image
Figure 1 Peripheral blood smear revealing the presence of Trypanosoma cruzi (A); Patient’s right facial palsy and spontaneous recover and after 30 days (authorized) (B); left facial nerve with normal motor amplitude (C); right facial nerve with decreased motor amplitude (D); left blink reflex with normal R1, R2, and absent R2’ (E); right blink reflex with absent R1 and R2, and normal R2’ (F).

#

Conflict of interest:

There is no conflict of interest to declare.

Authors’ contribution:

de Melo ES: study design, patient data collection and manuscript writing. Barbosa BJAP: manuscript writing. Lima CFLS, Silva MMM, Lima ARMC, Batista FP and Valença LPAA: data interpretation and manuscript critical revision.


  • References

  • 1 Fortes-Rêgo J. [Peripheral facial paralysis, polyneuritis and chronic Chagas’ disease]. Arq Neuropsiquiatr. 1985 Dec;43(4):418-21. https://doi.org/10.1590/s0004-282x1985000400014
  • 2 Bern C. Chagas’ Disease. N Engl J Med. 2015 Jul;373(5):456-66. https://doi.org/10.1056/nejmra1410150
  • 3 Alarcón de Noya B, Ruiz-Guevara R, Noya O, Noya O, Castro J, Ossenkopp J, et al. Long-term comparative pharmacovigilance of orally transmitted Chagas disease: first report. Expert Rev Anti Infect Ther. 2017 Mar;15(3):319-25. https://doi.org/10.1080/14787210.2017.1286979

Address for correspondence

Eduardo Sousa de Melo

Publication History

Received: 26 June 2020

Accepted: 01 July 2020

Article published online:
01 June 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

  • References

  • 1 Fortes-Rêgo J. [Peripheral facial paralysis, polyneuritis and chronic Chagas’ disease]. Arq Neuropsiquiatr. 1985 Dec;43(4):418-21. https://doi.org/10.1590/s0004-282x1985000400014
  • 2 Bern C. Chagas’ Disease. N Engl J Med. 2015 Jul;373(5):456-66. https://doi.org/10.1056/nejmra1410150
  • 3 Alarcón de Noya B, Ruiz-Guevara R, Noya O, Noya O, Castro J, Ossenkopp J, et al. Long-term comparative pharmacovigilance of orally transmitted Chagas disease: first report. Expert Rev Anti Infect Ther. 2017 Mar;15(3):319-25. https://doi.org/10.1080/14787210.2017.1286979

   Permissions and Reprints
Zoom Image
Figure 1 Peripheral blood smear revealing the presence of Trypanosoma cruzi (A); Patient’s right facial palsy and spontaneous recover and after 30 days (authorized) (B); left facial nerve with normal motor amplitude (C); right facial nerve with decreased motor amplitude (D); left blink reflex with normal R1, R2, and absent R2’ (E); right blink reflex with absent R1 and R2, and normal R2’ (F).