title: [Research of Lyme's disease in facial paralysis. A French multicenter study].
abstract: OBJECTIVE
  Apparent a frigore facial palsy could possibly mask manifestations of unrecognized Lyme's disease. Since commonly used corticosteroid treatment could be deleterious if Borrelia burgdorferi infection was indeed the cause, we conducted a prospective study to search for possible infections in cases of recently diagnosed a frigore facial palsy.
  
  
  METHODS
  For 3 years, 1990-1992, 49 French centres diagnosed a facial palsy in 346 patients (310 adults, 36 children under 15 years of age; mean age 38; range 16 months to 83 years). The patients were divided into three groups: a) facial palsy alone, b) zoster origin recognized due to outer ear eruption and c) cases with meningoradiculitis or joint signs or cases with facial diplegia. A questionnaire was used to evaluate exposure to risk of tick bits. A control group was established with 246 serum samples from subjects matched with the patients for age, geographical origin and exposure to risk of tick bits. Laboratory tests (indirect immunofluorescence and Western blot) were performed to search for anti-Borrelia burgdorferi antibodies in serum samples, and cerebral spinal fluid when possible, collected at presentation, on day 30 and on day 90.
  
  
  RESULTS
  Sixty percent of the patients were urban dwellers, 15% lived in rural and 25% in semi-rural areas. There were 294 patients with facial palsy alone and their serum results were compared with those of the matched controls. There was no significant difference in the positivity for Borrelia burgdorferi antibodies between these two groups.
  
  
  CONCLUSIONS
  These findings indicate that, unless there are clinical signs suggestive of borreliosis, it would not be necessary to test for Lyme's disease in patients with apparent a frigore facial palsy.
authors.affiliation: Service de Médecine interne et Gastroentérologie, Centre Hospitalier, Senlis.
authors.forename: M
authors.initials: M
authors.lastname: Ruel
authors.forename: J P
authors.initials: JP
authors.lastname: Arzouni
authors.forename: G
authors.initials: G
authors.lastname: Tailame
authors.forename: D
authors.initials: D
authors.lastname: Postic
authors.forename: G
authors.initials: G
authors.lastname: Freyss
authors.forename: D
authors.initials: D
authors.lastname: Raoult
authors.forename: P
authors.initials: P
authors.lastname: Saint Laurent
authors.forename: C
authors.initials: C
authors.lastname: Penalba
authors.forename: E
authors.initials: E
authors.lastname: Truy
authors.forename: B
authors.initials: B
authors.lastname: Flori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015153:Blotting, Western; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005158:Facial Paralysis / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000382:microbiology; D005260:Female; D005455:Fluorescent Antibody Technique; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008193:Lyme Disease / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values
vernacular_title: Recherche de maladie de Lyme dans les paralysies faciales. Une étude multicentrique Française.