Long-term findings in patients with facial palsy and antibodies against Borrelia burgdorferi.
Little is known about the long-term effects of Borrelia burgdorferi (Bb) infection in untreated patients with peripheral facial palsy. We investigated 12 patients with elevated serum Bb antibody levels, with a median follow-up time of 11 years, during which 3 of the 12 still exhibited intrathecal antibody production of antibodies against Bb flagellar antigen, and 2 of the 3 had normal serum Bb antibodies. Four of the 12 had elevated serum antibody titres at the late follow-up examination. Arthralgia, reported by 7 patients, was the single most common complaint. Four patients showed extensive oculomotor disturbances, which were not correlated to antibody titres or intrathecal antibody synthesis. In 1 of the patients with intrathecal Bb antibody production, most symptoms were eradicated by antibiotic treatment 6 years after the initial infection. We conclude that even several years after a Bb infection, intrathecal Bb antibody production can still occur in serum Bb IgG antibody negative patients with a history of facial palsy.
Department of Infectious Diseases, Faculty of Health Sciences, University Hospital, Linköping, Sweden.
M
M
Roberg
P
P
Forsberg
A
A
Frydén
B
B
Hederstedt
D
D
Hydén
L
L
Odkvist
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000032:analysis* / Q000134:cerebrospinal fluid; D001299:Audiometry; D015748:Borrelia burgdorferi Group / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004584:Electronystagmography; D005158:Facial Paralysis / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged
D000907:Antibodies, Bacterial