Characteristics and outcome of facial nerve palsy from Lyme neuroborreliosis in the United States

Marques, Adriana; Okpali, Grace M.; Liepshutz, Kelly; Ortega-Villa, Ana M

doi:10.1002/acn3.51488

Cited by 19 publications

(17 citation statements)

References 41 publications

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“…There is a disturbing phenomenon, which has also been demonstrated by Swedish researchers, where the occurrence of EM before the episode of NB concerned 36% of the examined children [18]. This percentage is lower in the USA and amounts to only 15%, although the studies concerned the entire infected population, without distinguishing children [19]. Variations in the clinical manifestations of LB between the US and Europe are associated with differences in BB species causing the infection; this observation highlights the need for ongoing education in the diagnosis of EM in the paediatric population.…”

Section: Z -Mann-whitney U Test's Value P -Probability Levelmentioning

confidence: 72%

Lyme borreliosis in children – trends in epidemiology. A single-centre study

Myszkowska-Torz¹,

Mazur-Melewska²,

Tomaszewski³

et al. 2023

polp

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Introduction:The aim of the study was to assess the changing incidence of Lyme borreliosis (LB) in a children's group in Wielkopolska, and the influences of gender and age as well as erythema migrans (EM) occurrence on the development of various forms of LB in children. Material and methods:Retrospective analysis covered the medical records of 206 children diagnosed with LB, hospitalised in the Department of Infectious Diseases and Child Neurology in Poznań and consulted at its Clinic of Infectious Diseases from 1 January 2012 to 30 October 2021. For an epidemiological analysis, the study population was limited to patients from Wielkopolska. A total of 196 qualified subjects were divided into 2 time periods, the first covering the years 2012-2016, in which LB was confirmed in 52 children, and the second covering 2017-2021, in which the disease was diagnosed in 144 children. The relationship between the course of LB and the gender and age of the patients was analysed in both groups. Statistical analysis of the data was performed, and the results were compared with published data. Results: The epidemiological analysis showed a more than a twofold increase in the number of LB cases in the analysed time periods, mainly diagnosed as EM. The high incidence of LB neurological complications in children, including those with incorrectly diagnosed EM, remains constant. There was no relationship between the clinical forms of the disease and the child's sex, but an increase in the number of EM diagnoses in younger children was confirmed. Conclusions:The study confirmed the increase in the number of LB diagnoses, analogous to the entire population of the region. The significant increase in the number of early stages of the disease and the frequent occurrence of neurological complications in children with undiagnosed and untreated EM indicate the need for ongoing education in the diagnosis of LB.

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Section: Z -Mann-whitney U Test's Value P -Probability Levelmentioning

confidence: 72%

Lyme borreliosis in children – trends in epidemiology. A single-centre study

Myszkowska-Torz¹,

Mazur-Melewska²,

Tomaszewski³

et al. 2023

polp

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“…It is assumed that the pathogenetic mechanism of the SSNHL in Lyme disease is related both to an immunological reaction and to an angiopathic injury of the cochlea 17,21,22 . On the contrary, facial nerve involvement seems to be related only to an aspecific inflammatory process 19,23 . According to the current literature, the diagnosis of neuroborreliosis requires meeting the following criteria: neurologic signs compatible with Lyme neuroborreliosis, CSF pleocytosis (>5 cells × 10 9 L), intrathecal production of specific antibodies ( B. burgdoferi IgM and/or IgG) 4,5 .…”

Section: Discussionmentioning

confidence: 99%

“…17,21,22 On the contrary, facial nerve involvement seems to be related only to an aspecific inflammatory process. 19,23 According to the current literature, the diagnosis of neuroborreliosis requires meeting the following criteria: neurologic signs compatible with Lyme neuroborreliosis, CSF pleocytosis (>5 cells × 10 9 L), intrathecal production of specific antibodies (B. burgdoferi IgM and/or IgG). 4,5 Other aspecific criteria are elevated levels of CRP and CXCL 13 presence in CSF.…”

Section: Discussionmentioning

confidence: 99%

Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy

Nitro

Martino

Fuccillo

et al. 2022

Clinical Case Reports

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We present a case of sudden sensorineural hearing loss and rapidly progressive facial palsy in a female patient in her 40s with no, apparently, notable past medical or surgical history. Investigations revealed a positive serology for B. burgdoferi and the MRI allowed us to identify suggestive signs of Lyme meningitis with multiple cranial nerve involvement. After diagnosis, the patient was treated with intravenous ceftriaxone with a full recovery of sensorineural deafness and facial palsy. This case report highlights the importance of collecting a complete medical history in all cases of facial palsy and sudden hearing loss while presenting an infrequent clinical presentation of early disseminated Lyme disease with neuroborreliosis.

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“…13 No. 6 2022 Symptoms of facial nerve palsy usually completely resolve within one to two months of ATB treatment [16]. Nevertheless, in 5-10% of cases a residual paresis of facial nerve is observed even several months after treatment [17,18].…”

Section: Discussionmentioning

confidence: 99%

Socio-demographic Characteristics of Tick Bite and Erythema migrans not associated with the Diagnosis of Neuroboreliosis

Koscalova¹,

Holeckova²,

Gazdikova³

et al. 2022

CSWHI

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Introduction Lyme neuroborreliosis (LNB) is a tick-borne infection caused by bacteria Borrelia burgdorferi sensu lato that accounts for 10-15% of all Lyme borreliosis cases in Europe. LNB can present with a variety of neurological manifestations. We aimed to describe the typical anamnestic, clinical and laboratory features of patients diagnosed with LNB and to describe the differences between paediatric and adult cases. Additionally, we assessed the factors associated with definite LNB. Methods We retrospectively evaluated data of patients with suspected LNB had undergone lumbar puncture and were admitted to the Infectious diseases department of University hospital Bratislava, Slovakia, between September 2019 and May 2022. Patients were divided into three categories according to the diagnostic criteria of European Federation of Neurological Societies: A) cases with definite LNB, B) cases with possible LNB, C) non-LNB controls. Results In total, 139 patients were included in the analysis. 32 individuals were classified as definite LNB, 23 as possible LNB and 84 as non-LNB controls. 55.5% were females and 35.3% were children aged<18 years. 56.3% of patients with definite LNB reported a history of tick bite, and 21.9% a history of erythema migrans (EM). Peripheral facial nerve palsy (PFNP) was the most common clinical symptom in patients with definite LNB (65.6%), followed by headache (50.0%), fever (21.9%) and radicular pain (18.8%). In a univariate and multivariable analyses neither history of tick bite nor history of EM were significantly associated with definite LNB. Factors independently associated with definite LNB in multivariable analyses were (i) age < 18 years (aOR 7.89, 95% CI 2.00-31.03, p < 0,003), (ii) female gender (OR 6.34; 95% CI 1.66-24.17, p < 0.007), and (iii) facial nerve palsy (OR 10.54; 95% CI 2.41-55.19, p < 0.002). Conclusion We found that peripheral facial nerve palsy is the strongest predictor of definite LNB, and that the children<18 years and females in our study were more likely to be diagnosed with LNB. Our study also suggests that anamnestic data on history of tick bite and EM contribute little to the diagnosis of LNB and that the examination of CSF is essential for the diagnosis of LNB.

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Characteristics and outcome of facial nerve palsy from Lyme neuroborreliosis in the United States

Cited by 19 publications

References 41 publications

Lyme borreliosis in children – trends in epidemiology. A single-centre study

Lyme borreliosis in children – trends in epidemiology. A single-centre study

Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy

Socio-demographic Characteristics of Tick Bite and Erythema migrans not associated with the Diagnosis of Neuroboreliosis

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