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Paediatric facial paralysis caused by Lyme borreliosis: a prospective and retrospective analysis
M Peltomaa1, H Saxen, I Seppälä
1Department of Otolaryngology, Helsinki University Central Hospital, Finland.
Insights
Lyme borreliosis (LB) frequently causes acute facial palsy (FP) in children. Studies indicate childhood LB-associated facial palsy has a favorable prognosis, even without antibiotic treatment.
Area of Science:
- Pediatric Infectious Diseases
- Neurology
- Dermatology
Background:
- Facial palsy (FP) is common in children.
- Lyme borreliosis (LB) is an emerging tick-borne illness.
- The association between LB and pediatric FP requires further investigation.
Purpose of the Study:
- To determine the incidence of LB in children with acute FP.
- To evaluate the long-term outcomes of FP in children, specifically concerning LB.
- To assess the prognosis of LB-associated FP in pediatric patients.
Main Methods:
- Prospective study of 49 children with 50 episodes of acute FP.
- Retrospective study of 43 children with a history of FP for long-term outcomes.
- Clinical evaluation for signs and symptoms of acute and late Lyme borreliosis.
Main Results:
- Lyme borreliosis was diagnosed in 17 (34%) of children with acute FP.
- All children with LB-related FP received antibiotics and had favorable outcomes.
- Children with a history of FP, even untreated for LB, showed favorable outcomes and no signs of late LB.
Conclusions:
- Lyme borreliosis is a significant cause of acute pediatric facial palsy in endemic regions.
- Pediatric facial palsy caused by LB appears to have a favorable prognosis.
- Further research may clarify optimal management strategies for LB-associated FP in children.
Abstract:
The incidence of Lyme borreliosis (LB) was studied prospectively in 49 children (< 17 years of age) with 50 episodes of acute FP. In addition, 43 children with a history of FP (average follow-up of 5.2 y) were studied retrospectively for the outcome of FP and for the symptoms and signs of late LB. In the prospective study, 17 (34%) patients with FP proved to have acute LB. They all received antibiotic treatment and their FP had a favourable outcome. In the retrospective study the patients had had FP before the diagnostic tests for LB were available. Thus, none of the 43 patients had been diagnosed to have, or treated for, LB. The outcome of their FP had generally been favourable. None of them had any signs of late LB at the follow-up visit. Our results indicate that LB is a frequent cause of acute paediatric FP in an endemic area. In addition our data suggests that FP caused by LB in children has a favourable prognosis, even when left untreated.