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Lyme borreliosis and facial paralysis–a prospective analysis of risk factors and outcome.

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Abstract

PURPOSE:

To evaluate the incidence of
Lyme borreliosis in patients with acute idiopathic facial paralysis with special emphasis on the risk factors that explain the poor outcome of facial paralysis and occurrence of
Lyme borreliosis.

MATERIALS AND METHODS:

During a 2-year period, we prospectively studied 503 consecutive patients with acute idiopathic facial paralysis for the presence of
Lyme borreliosis. We screened the patients for antibodies to Borrelia burgdorferi and for symptoms or signs related to
Lyme borreliosis. Chi-square and logistic regression tests were used for the statistical analysis. Special attention was paid to strict criteria for the diagnosis of
Lyme borreliosis.

RESULTS:

Eleven (2.2%) of the 503 patients with facial paralysis had
Lyme borreliosis. Fever, headache, pharyngalgia, enlarged cervical lymph nodes, bilateral paralysis, and arthralgia were more common in patients with
Lyme borreliosis than in those without it. In the logistic regression modeling the best combination of explanatory variables for predicting the occurrence of
Lyme borreliosis included summer season at the onset of facial paralysis, presence of enlarged cervical lymph nodes, and arthralgia. The best combination of explanatory variables to predict the poor outcome of facial paralysis was total paralysis of facial nerves, recurrent facial paralysis, and hyperacusis.

CONCLUSIONS:

Lyme borreliosis is an important infectious cause of facial paralysis. In our study, 11 of 503 patients with acute idiopathic facial paralysis had
Lyme borreliosis. The screening for serum antibodies in addition to the thorough evaluation of the history of the patient and of the patient’s clinical signs or symptoms possibly linked with
Lyme borreliosis, are essential when diagnosing
Lyme borreliosis.

Copyright 2002, Elsevier Science (USA). All rights reserved.)

Am J Otolaryngol. 2002 May-Jun;23(3):125-32. Research Support, Non-U.S. Gov’t

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