Leprosy and HIV can cause recurrent facial palsy

Thirupathirajan and Thinakararajan discuss the differential diagnosis of recurrent facial palsy.1 A few important differentials, such as those between leprosy and HIV, are left out.Leprosy, especially tuberculoid type, is an important contributor to bilateral and occasionally unilateral lower motor neurone type facial palsy. The diagnosis is mainly clinical and detection of PGL-1 by enzyme-linked immunosorbent assay (ELISA) is used as serological diagnosis of leprosy, although it is positive in 60% of tuberculoid leprosy cases.23HIV serology should be performed to rule out HIV infection. HIV infection can cause facial palsy at any stage.456
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