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Peripheral facial palsy caused by the Borrelia spirochete
A Bjerkhoel1, M Carlsson, J Ohlsson
1Department of Otorhinolaryngology, Länssjukhuset Ryhov, Jönköping, Sweden.
Abstract:
Forty-three consecutive patients with peripheral facial palsy were examined to evaluate the incidence of facial palsy caused by the tick-borne Borrelia spirochete in a non-coastal area in the south of Sweden. Six (14%) of the patients were found to have a Borrelia infection. The incidence of Borrelia-induced facial palsy was 0.39/10,000 inhabitants, which is less than in neighbouring coastal areas but still high enough to cause serious concern when dealing with facial palsies. In contrast to Bell's palsy, a Borrelia infection can cause serious generalized illness if not properly treated. Negative Borrelia serology of the serum and the cerebrospinal fluid (CSF) and a normal CSF analysis did not exclude the Borrelia etiology. Tick bites, signs of polyneuropathy, meningeal symptoms and Borrelia-associated erythema proved to be important signs for the diagnosis.
Insights
Facial palsy in southern Sweden is sometimes caused by Borrelia infection, a tick-borne illness. Early diagnosis is crucial as untreated Borrelia can lead to serious generalized illness, unlike Bell's palsy.
Area of Science:
- Neurology
- Infectious Diseases
- Epidemiology
Background:
- Peripheral facial palsy is a common neurological condition.
- Tick-borne Borrelia spirochetes are known causes of facial palsy, particularly in coastal regions.
- The incidence and diagnostic challenges of Borrelia-induced facial palsy in non-coastal areas require further investigation.
Purpose of the Study:
- To determine the incidence of facial palsy caused by Borrelia infection in a non-coastal area of southern Sweden.
- To identify key clinical signs and diagnostic indicators for Borrelia-induced facial palsy.
- To compare Borrelia-induced facial palsy with idiopathic Bell's palsy.
Main Methods:
- Prospective examination of 43 consecutive patients with peripheral facial palsy.
- Serological testing for Borrelia infection in serum and cerebrospinal fluid (CSF).
- Analysis of CSF for abnormalities and assessment for clinical signs such as tick bites, polyneuropathy, meningeal symptoms, and erythema.
Main Results:
- Six out of 43 patients (14%) were diagnosed with Borrelia infection.
- The incidence of Borrelia-induced facial palsy was calculated as 0.39 per 10,000 inhabitants.
- Negative serology and normal CSF analysis did not rule out Borrelia etiology, highlighting the importance of clinical signs.
Conclusions:
- Borrelia infection is a significant, though less common, cause of facial palsy in non-coastal southern Sweden compared to coastal areas.
- Clinical indicators like tick bites, polyneuropathy, meningeal symptoms, and erythema are vital for diagnosing Borrelia-induced facial palsy.
- Prompt and accurate diagnosis of Borrelia-induced facial palsy is essential to prevent potential serious generalized illness.