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Journal of Neurology

, Volume 252, Issue 6, pp 672–676 | Cite as

Acute peripheral facial palsy in adults

  • Unn Ljøstad
  • S. Økstad
  • Th. Topstad
  • Å. Mygland
  • P. Monstad
ORIGINAL CONTRIBUTION

Abstract

Objective

To collect epidemiological data of peripheral facial palsy, and especially to chart the incidence and clinical characteristics of Lyme associated facial palsy.

Material and methods

We included consecutive adult patients presenting with peripheral facial palsy in Vest–Agder County from January 1997 to December 1998. The facial palsy was graded according to the House and Brackman facial function scoring system,and cerebrospinal fluid and serum samples were examined for Borrelia burgdorferi antibodies and virus antibodies. Final outcome was evaluated by follow up visits or telephone interview.

Results

Sixty nine patients were included and followed until complete recovery, or for 5 years. Ten per cent were caused by Lyme disease, 17% by virus infection, 4% by other causes and 68% were classified as Bell’s palsy. All patients with Lyme facial palsy had additional neurological symptoms, and 87% reported constitutional complaints. The overall final outcome was good with complete recovery in 77%, slight sequelae in 20% and moderate sequelae in 3%. No patients experienced severe sequelae. Two of 28 patients examined with neurography had absent compound muscle action potentials in orbicularis oculi. Both made good recovery with only slight sequelae.

Conclusions

Peripheral facial palsy is a common disorder with a favourable prognosis. Lyme disease seems to be an infrequent cause of facial palsy in patients without constitutional symptoms or additional neurological findings.

Key words

facial paralysis lyme disease 

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References

  1. 1.
    Rowlands S, Hooper R, Hughes R, Burney P (2002) The epidemiology and treatment of Bell’s palsy in the UK. Eur J Neurol 9:63–67CrossRefPubMedGoogle Scholar
  2. 2.
    Gilbert SC (2002) Bell’s palsy and herpesviruses. Herpes 9:70–73PubMedGoogle Scholar
  3. 3.
    Grogan PM, Gronseth GS (2001) Practice parameter: Steroids, acyclovir, and surgery for Bell’s palsy (an evidencebased review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 56:830–836PubMedGoogle Scholar
  4. 4.
    Peitersen E (2002) Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl:4–30Google Scholar
  5. 5.
    Ljostad U, Mygland A, Skarpaas T (2003) Neuroborreliosis in Vest-Agder. Tidsskr Nor Laegeforen 123:610–613PubMedGoogle Scholar
  6. 6.
    Smith IM, Murray JA, Cull RE, Slattery J (1992) A comparison of facial grading systems. Clin Otolaryngol 17:303–307PubMedGoogle Scholar
  7. 7.
    Hyden D, Roberg M, Forsberg P, Fridell E, Fryden A, Linde A, Odkvist L (1993) Acute “idiopathic” peripheral facial palsy: clinical, serological, and cerebrospinal fluid findings and effects of corticosteroids. Am J Otolaryngol 14:179–186CrossRefPubMedGoogle Scholar
  8. 8.
    Peltomaa M, Pyykko I, Seppala I, Viljanen M (2002) Lyme borreliosis and facial paralysis–a prospective analysis of risk factors and outcome. Am J Otolaryngol 23:125–132CrossRefPubMedGoogle Scholar
  9. 9.
    Kohler A, Chofflon M, Sztajzel R, Magistris MR (1999) Cerebrospinal fluid in acute peripheral facial palsy. J Neurol 246:165–169CrossRefPubMedGoogle Scholar
  10. 10.
    Lotric-Furlan S, Cimperman J, Maraspin V, Ruzic-Sabljic E, Logar M, Jurca T, Strle F (1999) Lyme borreliosis and peripheral facial palsy. Wien Klin Wochenschr 111:970–975PubMedGoogle Scholar
  11. 11.
    Engervall K, Carlsson-Nordlander B, Hederstedt B, Berggren D, Bjerkhoel A, Carlborg A, Grenner J, Hanner P, Hogmo A, Isholt RM (1995) Borreliosis as a cause of peripheral facial palsy: a multi-center study. ORL J Otorhinolaryngol Relat Spec 57:202–206PubMedGoogle Scholar
  12. 12.
    Halperin JJ, Logigian EL, Finkel MF, Pearl RA (1996) Practice parameters for the diagnosis of patients with nervous system Lyme borreliosis (Lyme disease).Quality Standards Subcommittee of the American Academy of Neurology. Neurology 46:619–627PubMedGoogle Scholar
  13. 13.
    Halperin JJ (2003) Facial nerve palsy associated with lyme disease. Muscle Nerve 28:516–517PubMedGoogle Scholar
  14. 14.
    Smouha EE, Coyle PK, Shukri S (1997) Facial nerve palsy in Lyme disease: evaluation of clinical diagnostic criteria. Am J Otol 18:257–261PubMedGoogle Scholar
  15. 15.
    Tysnes OB, Hofstad H, Jacobsen H (1992) Peripheral facial paresis as a symptom of Borrelia burgdorferi infection. Tidsskr Nor Laegeforen 112:50–51PubMedGoogle Scholar
  16. 16.
    Kuiper H, Devriese PP, de Jongh BM, Vos K, Dankert J (1992) Absence of Lyme borreliosis among patients with presumed Bell’s palsy. Arch Neurol 49:940–943PubMedGoogle Scholar
  17. 17.
    Roberg M, Ernerudh J, Forsberg P, Fridell E, Fryden A, Hyden D, Linde A, Odkvist L (1991) Acute peripheral facial palsy: CSF findings and etiology. Acta Neurol Scand 83:55–60PubMedGoogle Scholar
  18. 18.
    Redaelli de Zinis LO, Gamba P, Balzanelli C (2003) Acute otitis media and facial nerve paralysis in adults. Otol Neurotol 24:113–117CrossRefPubMedGoogle Scholar
  19. 19.
    Olsen PZ (1975) Prediction of recovery in Bell’s palsy. Acta Neurol Scand 61 (Suppl):1–121Google Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  • Unn Ljøstad
    • 1
  • S. Økstad
    • 2
  • Th. Topstad
    • 2
    • 4
  • Å. Mygland
    • 1
    • 3
  • P. Monstad
    • 1
  1. 1.Dept. of NeurologySørlandet Sykehus HF, KristiansandKristiansandNorway
  2. 2.Dept. of ENTSørlandet Sykehus HFKristiansandNorway
  3. 3.Spesialsykehuset for rehabilitering HFKristiansandNorway
  4. 4.Dept. of reconstructive surgery Yehatit 12 HospitalEthiopia

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