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Pediatric facial paralysis--a spirochetal infection with good prognosis?
M Peltomaa1, H Saxen, I Pyykkö
1Department of Otolaryngology, Helsinki University Hospital, Sweden.
Insights
Children with facial paralysis rarely develop chronic Lyme borreliosis. This study found no chronic signs in participants, indicating a favorable prognosis for pediatric facial paralysis, even when caused by Borrelia burgdorferi infection.
Area of Science:
- Medical Research
- Pediatrics
- Infectious Diseases
Background:
- Facial paralysis in children can be linked to Lyme borreliosis.
- Previous studies suggest a high incidence of Lyme borreliosis in pediatric facial paralysis during specific seasons.
- Long-term effects of Lyme borreliosis in children with prior facial paralysis were not well-documented.
Purpose of the Study:
- To investigate signs of chronic spirochetal infection in children with a history of facial paralysis.
- To assess the long-term prognosis of pediatric facial paralysis potentially caused by Borrelia burgdorferi.
- To evaluate for chronic Lyme borreliosis symptoms in a cohort previously untreated for facial paralysis.
Main Methods:
- Clinical examination and laboratory testing of 27 children with a history of facial paralysis.
- Patient interviews focusing on Lyme borreliosis symptoms and signs.
- Serological testing for Borrelia burgdorferi antibodies.
Main Results:
- No patients exhibited signs or symptoms of chronic Lyme borreliosis.
- One child showed a recent Borrelia burgdorferi infection indicated by a 4-fold antibody rise.
- Facial paralysis demonstrated a favorable prognosis in short-term follow-up.
Conclusions:
- Pediatric facial paralysis, even if caused by Borrelia burgdorferi, generally has a good prognosis.
- Chronic Lyme borreliosis is uncommon in children following an episode of facial paralysis.
- Further research could explore long-term outcomes in larger cohorts.
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.