Facial paralysis in Lyme disease

Area of Science:

• Infectious Diseases
• Neurology
• Otolaryngology

Background:

• Lyme disease is a tick-borne illness with increasing prevalence globally.
• Facial paralysis is a known complication, affecting up to 11% of patients.
• Historically, Lyme disease was geographically limited but is now widespread.

Purpose of the Study:

• To review the clinical presentation and outcomes of facial paralysis in Lyme disease patients.
• To evaluate the efficacy of conservative management versus surgical intervention.
• To emphasize the importance of considering Lyme disease in idiopathic facial palsies.

Main Methods:

• Retrospective review of 124 cases of facial palsy in 101 patients with Lyme disease.
• Data collected between 1975 and 1984.
• Analysis of clinical course, diagnostic features, and recovery rates.

Main Results:

• A spontaneous recovery rate of 99.2% was observed for Lyme disease-associated facial palsy.
• Operative intervention was not found to be indicated.
• Positive Lyme disease spirochete titers aided in diagnosis.

Conclusions:

• Lyme disease-associated facial palsy has an excellent prognosis with conservative management.
• Otolaryngologists should consider Lyme disease in unexplained facial paralysis, particularly during summer in endemic areas or with bilateral presentation.
• Antibiotic therapy is advised for concurrent manifestations and to prevent future complications.