BORRELIOSIS AS A CAUSE OF PERIPHERAL FACIAL PALSY - A MULTICENTER STUDY

Borreliosis is known to be a common cause of peripheral facial palsy i n Stockholm and its vicinity. The aim of the present study was to inve stigate the frequency and characteristics of borreliosis among patient s with peripheral facial palsy in different parts of Sweden. All serol ogical tests were performed in one laboratory. Ten Swedish Ear Nose an d Throat clinics participated in a prospective 1-year study of patient s seeking medical attention for acute peripheral facial palsy. Twenty- eight (6%) out of totally 446 patients fulfilled the criteria for the diagnosis of borreliosis. The frequency varied between 1 and 16% and w as highest along the southeast coast of Sweden whereas no case was rep orted from the northern part of the country. Borreliosis was more comm on among children with facial palsy than among adults. The infection o ccurred during all seasons although it appears to be less frequent dur ing the spring months. Only a minority of the borrelial patients had a history of a preceding tick bite or erythema migrans. The fairly low overall frequency of this secondary stage of borreliosis in the study may be a result of better knowledge of the disease and earlier treatme nt of its early manifestations. In Sweden's endemic areas borreliosis is a common cause of peripheral facial palsy, and therefore all patien ts with facial palsy in these regions should be examined for borrelial infection.