Tick-borne spirochetes as a cause of facial palsy

Twenty consecutive patients visiting an otolaryngological department in Sweden with a facial palsy were investigated for serological signs of tick-borne spirochete infection. Four patients showed serological evidence of and had a medical history compatible with a tick-borne spirochetosis. Spinal fluid analyses were performed in 3 of these patients and showed elevated specific antispirochetal antibody titres and an increase in mononuclear cells. The importance of a correct diagnosis and of antibiotic therapy in patients with spirochete-induced facial palsy is emphasized.