Published online August 4, 2008
PEDIATRICS (doi:10.1542/peds.2007-3238)
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EXPERIENCE & REASON

Facial Nerve Palsy Complicating Kawasaki Disease

Helen Wright, MRCP, FRACPa,b, Claire Waddington, BMedSci, BMBSb, Janet Geddes, FRACPb, Jane Newburger, MD, PhDc and David Burgner, MD, PhDa,b

a School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
b Infectious Diseases and General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia
c Division of Cardiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts

ABSTRACT

The diagnosis of Kawasaki disease, the most common cause of pediatric acquired heart disease, is difficult and often delayed for children whose age falls outside the typical range of 6 months to 5 years, especially in those with incomplete Kawasaki disease and atypical features. Delayed diagnosis is associated with an increased incidence of coronary artery pathology. Here we describe 2 cases of lower motor neuron facial nerve palsy complicating Kawasaki disease. In both cases the diagnosis of Kawasaki disease was not made acutely, and both patients developed extensive coronary artery lesions. These cases highlight the importance of considering Kawasaki disease in children with unexplained prolonged fever at any age, particularly those without full diagnostic criteria and with unusual features.

Key Words: Kawasaki disease • facial nerve palsy • vasculitis

Abbreviations: KD, Kawasaki disease • CA, coronary artery • HSV, herpes simplex virus • IVIg, intravenous immunoglobulin • RCA, right coronary artery • LAD, left anterior descending coronary artery

Accepted Mar 17, 2008.