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Lyme-Borreliosis often presents as facial palsy. This progredient infectious
disease is to be treated by intravenous penicillin therapy in order to avoid future complications. In three out of four own observations facial palsy raised suspicion towards central origin. By performance of the orbicularis oculi reflex in all four cases peripheral damage of the facial nerve could be demonstrated. This simple electromyographic method seems to be a valuable tool in the differentiation of central and peripheral facial nerve palsy in childhood, preserving the affected children from painful electrodiagnostic procedure or useless search for supranuclear lesions.