Facial Palsy and Lyme Disease: A Study
Author Information
Author(s): Bremell Daniel, Hagberg Lars
Primary Institution: Sahlgrenska University Hospital
Hypothesis
Can clinical and cerebrospinal fluid parameters differentiate between Lyme neuroborreliosis and Bell's palsy in patients with peripheral facial palsy?
Conclusion
The study found that time of year, neurological symptoms, and mononuclear pleocytosis in cerebrospinal fluid are strong predictors of Lyme neuroborreliosis as a cause of peripheral facial palsy.
Supporting Evidence
- Patients with definite Lyme neuroborreliosis had significantly more neurological symptoms outside the paretic area of the face.
- The median CSF mononuclear cell count was significantly higher in the definite Lyme neuroborreliosis group compared to Bell's palsy.
- Patients with definite Lyme neuroborreliosis were older than those with Bell's palsy.
Takeaway
Doctors can tell if a patient has Lyme disease or Bell's palsy by looking at when they got sick and checking their spinal fluid.
Methodology
The study reviewed hospital records of patients with peripheral facial palsy who underwent lumbar puncture, classifying them based on the presence of Borrelia antibodies.
Potential Biases
There is a risk of misclassifying some patients due to the low sensitivity of certain diagnostic tests.
Limitations
The study may not fully represent all patients with Bell's palsy or Lyme neuroborreliosis due to its focus on adult patients at a specific hospital.
Participant Demographics
Patients included were adults with peripheral facial palsy, median ages were 36 for Bell's palsy and 46 for Lyme neuroborreliosis.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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