Lyme disease presenting with bilateral facial nerve palsy

Facial palsy bilateral, or recurrent, suggests a myriad of diagnostic possibilities. An 11-year-old boy is described whose diagnosis remained elusive for several months. Clinical evolution and subsequent laboratory studies confirmed that he had Lyme disease. Literature review suggests that this disorder is ubiquitous in its manifestations. The diagnosis should be remembered in unexplained neurologic disorders, particularly in cranial and peripheral neuropathies.