Peripheral facial nerve palsy in children in a Borrelia high-endemic area, a retrospective follow-up study.

Abstract

To identify the incidence, aetiology and prognosis of acute peripheral facial nerve palsy (FNP) in children in the Borrelia high-endemic region of Stockholm. The present study identified children from 0 to 18years of age who visited a paediatric emergency department for acute peripheral FNP during a 1-year period from 2014 to 2015. Data were collected retrospectively. The Sunnybrook and House-Brackmann facial grading systems were used to measure clinical outcome. A total of 77 children were identified with FNP, an estimated incidence of 30 per 100000 children/year. Forty-five children (58%) were diagnosed with neuroborreliosis, 28 (36%) with idiopathic FNP and four (6%) with other rarer causes. Neuroborreliosis was common from June to November and mainly seen in children below 10years of age. Six patients (8%) had remaining symptoms at least 3months after onset; three had idiopathic facial palsy (IFP) and were all older than 10years, one had neuroborreliosis and two had other causes. Neuroborreliosis and IFP were the major causes of FNP during the study period. Neuroborreliosis-associated facial palsy had a seasonal variation and dominated in younger ages.