Absence of Lyme borreliosis among patients with presumed Bell's palsy
H. Kuiper, P. P. Devriese, B. M. de Jongh, K. Vos and J. Dankert
Department of Neurology, University Hospital, University of Amsterdam, The Netherlands.
In a prospective study, 69 patients with a presumed idiopathic (Bell's)
peripheral facial palsy were clinically and serologically evaluated for the
presence of Lyme borreliosis. In addition, their clinical spectrum was
compared with clinical manifestations collected retrospectively in nine
patients with symptomatic peripheral facial palsy due to Lyme borreliosis.
The seroprevalence of Borrelia burgdorferi antibodies, determined by
flagellum enzyme-linked immunosorbent assay, among 69 patients with
idiopathic peripheral facial palsy (6%) and 153 healthy controls (4.5%) was
not significantly different (odds ratio, 1.28; 95% confidence interval,
0.27 to 5.25). None of the patients with idiopathic peripheral facial palsy
had or experienced the development of Lyme borreliosis. All patients with
Lyme peripheral facial palsy had additional manifestations not present in
patients with idiopathic peripheral facial palsy. These findings show that
patients with a Lyme peripheral facial palsy can be differentiated from
patients with idiopathic peripheral facial palsy by clinical examination.
Therefore, screening of antibodies to B burgdorferi among patients with
idiopathic peripheral facial palsy without additional manifestations is not
recommended.
