10. AN OUTBREAK OF BELLS'S PALSY CAUSED BY BORRELIA BURGDORFERI IN HUNGARY

Abstract

The first LGB patients in Hungary were diagnosed in 1984, and a few more in 1985. But only following the introduction of serological tests (indirect immunofluorescence) in 1986 that interest in the illness was aroused. During the last two years more than 2000 sera and CSF samples from 1400 patients have been tested for Borrelia burgdorferi antibody. 92 of 1400 patients suffered from peripheral facial palsy. 35/92 were found to be serologically positive. 19 of them were seen during the summer and fall of 1987. In this year twice as many Dell's palsy patients were seen in our hospitals than in previous years. Of the 35 clinically and serologically proven cases: 14 showed ECM; 10 had other neurological manifestations (Bannwarth's syndrome); 1 had frank arthritis; 1 had carditis. 18/33 seropositlve Bell's palsy patients were children. The clinical picture, epidemiology, serology and CSF findings of these cases will be discussed. Almost all of the seropositive patients became free of symptoms. The longest period of recovery was 100 days. Residual symptom was found only in those patients that remained seronegative during a minimum of 45 days serological follow-up period or did not receive adequate parenteral antibiotic therapy. Half of the seropositlve patients had lymphocytlc meningitis. Only one seronegative case had pleocytosis in the CSF.