Lyme Borreliosis — Main Cause of Acute Peripheral Facial Palsy in Childhood

Abstract

The epidemiology and clinical features of acute peripheral facial palsy with respect to Lyme borreliosis were investigated in a prospective multicenter study. The study included seven pediatric departments serving a geographically well-defined region in Lower Saxony with a population of 350000 children. During a 3-year period (1987 – 1989), 76 consecutive cases with acute peripheral facial palsy were investigated. On the basis of their CSF findings 137 additional pediatric cases with facial palsy were included. They were examined by the same serological methods in our laboratory as the 76 cases but treated in other hospitals not participating in the multicenter study. Diagnosis of Lyme borreliosis was based on the detection of specific IgM antibodies against Borrelia burgdorferi in CSF, using an IgM capture assay. The demonstration of specific IgM and/or IgG antibodies in serum alone was not considered to be sufficient for the diagnosis of Lyme borreliosis.