Please read Dr. Murphy’s article in the Journal of Child Neurology titled, “Seroprevalence of Lyme Disease in Children with Facial Nerve Palsy.“
Lyme disease is a multisystem tick-borne infectious illness caused by Borrelia burgdorferi affecting more than 450 000 individuals annually in the United States, primarily in the Northeast. Clinical manifestations of Lyme disease can include erythema migrans, facial nerve palsy, and/or meningitis but are typically nonspecific including fever, fatigue, headache, arthralgia, and myalgia. Lyme disease has long been associated with facial nerve palsy particularly in endemic regions, especially during summertime. One study in a Lyme-endemic region found Lyme disease to be the most common cause of transient facial nerve palsy in children (50%) when compared to idiopathic or other established causes of facial nerve palsy, such as acute otitis media and varicella infection. Although the association between Lyme disease and facial nerve palsy is widely accepted, the prevalence of Lyme disease among patients with facial nerve palsy varies widely between studies. Publications involving adult patients with facial nerve palsy have reported rates of Lyme disease from 2% to 25% among their cohorts, whereas those involving pediatric patients range from 34% to 65%. Nigrovic et al note that studies involving pediatric patients with facial nerve palsy report higher rates of Lyme disease compared with those involving adult patients, suggesting that children with facial nerve palsy may be more vulnerable than their adult counterparts.