Pediatric Facial Paralysis—A Spirochetal Infection with Good Prognosis?

Abstract

The aim of the study was to investigate the possible signs of chronic spirochetal infection in 27 children with a history of facial paralysis with onset of symptoms during May-October 1985–1993. These children had not been studied at the time of facial paralysis for possible Lyme borreliosis and none of these children had received antimicrobial therapy at that time. The patients were interviewed with special reference to symptoms and signs of Lyme borreliosis and thereafter examined clinically and with laboratory tests. None of the patients showed signs or symptoms of chronic Lyme borreliosis. One child—now a 14-year old girl—had a 4-fold rise in serum Borrelia burgdorferi antibodies as a sign of a recent infection. According to our prospective studies on pediatric facial paralysis in Finland (over 50% of children presenting with facial paralysis during May-October have Lyme borreliosis), we have a reason to assume that at least some in our study group had a facial paralysis caused by Borrelia burgdorferi infection. The results of our study indicate that facial paralysis has a favorable prognosis and in short-term follow-up the children do not have symptoms or signs of chronic Lyme borreliosis.

Key Words:

• Lyme disease
• Bell's palsy
• facial paralysis
• serology
• cererospinal fluid analysis
• polymerase chain reaction