Successful oral doxycycline treatment of Lyme disease-associated facial palsy and meningitis

Twenty-nine patients, aged 11-79 years (mean, 50 years), with Lyme neurobor reliosis, facial nerve palsy, and meningitis were treated with oral doxycyc line (daily dose, 200-400 mg) for 9-17 days in a prospective, nonrandomized study. Facial paresis was bilateral in eight (28%) of the 29 patients. Twe nty-six patients (90%) recovered without sequelae within 6 months, while th ree of the patients with bilateral facial palsy at admission had remaining paresis at follow-up. In five patients, contralateral facial paresis develo ped 1-12 days after initiation of therapy, and two patients were retreated with antibiotics. Posttreatment examinations of cerebrospinal fluid showed a marked decrease of inflammatory cells and protein concentrations compared with pretreatment levels in all followed up patients. The favorable clinic al outcome agrees with findings of other reports on intravenous antibiotic therapy for Lyme disease-associated meningitis with facial palsy. Our concl usion is that oral doxycycline is an effective and convenient therapy for L yme disease-associated facial palsy.