The degree of damage in the peripheral facial nerve palsy in children depending on the cause: The role of Lyme neuroborreliosis

Introduction Symptoms of peripheral facial nerve paralysis occur in patients of all age groups. Etiology of this disease is very diverse. Aim The aim of this work is to estimate facial nerve damage in relation to presumable cause, including cases in which Lyme neuroborreliosis has been confirmed by laboratory testing. Material and methods Thirty-three patients with symptoms of facial nerve paralysis were examined from January to September 2012 in the Department of Pediatric Neurology of the Provincial Specialist Children's Hospital in Olsztyn. Facial nerve function was classified on a three-stage scale created by the authors of this work. Full neurological examination was performed in all patients. Laboratory tests for Lyme-specific antibodies IgG and IgM by enzyme-linked immunosorbent assay has also been performed. Results and discussion In the study group, diagnosis of Lyme neuroborreliosis was confirmed in nine patients. Analysis shows that the stage of facial nerve damage in the group with Lyme disease was significantly heavier and that percentage of mild paralysis was significantly higher in the group of patients in whom Lyme disease has not been confirmed. Conclusions The role of neuroborreliosis among the infectious factors ought to be emphasized. It seems significant that in patients with confirmed Lyme disease the stage of facial nerve damage was considerably deeper and the recovery was slower.