Bell’s Palsy Associated with Chronic HCV Infection Before and During Peginterferon Alfa and Ribavirin Therapy

Neuropsychiatric side effects of peginterferon-alfa (PEG-IFN-alfa) therapy consist of a large spectrum of symptoms. Organic personality syndrome, organic affective syndrome, psychotic manifestations and seizures are more common side effects of PEG-IFN-alfa whereas cranial neuropathy and movement disorders are less common. Bell’s palsy is often idiopathic, but has been linked to some viral infections, particularly with herpes viruses. Other infections, such as human immunodeficiency virus infection and Lyme disease, may also lead to idiopathic facial paralysis. Neither acute nor chronic Hepatitis C infection has been implicated previously in Bell’s palsy, but PEG-IFN-alfa may play a role. Two patients with CHC who developed Bell’s palsy before and during treatment with PEG-IFN-alfa and Ribavirin are presented here.