Acute peripheral facial palsy in adults.
OBJECTIVE
To collect epidemiological data of peripheral facial palsy, and especially to chart the incidence and clinical characteristics of Lyme associated facial palsy.


METHODS
We included consecutive adult patients presenting with peripheral facial palsy in Vest-Agder County from January 1997 to December 1998. The facial palsy was graded according to the House and Brackman facial function scoring system,and cerebrospinal fluid and serum samples were examined for Borrelia burgdorferi antibodies and virus antibodies. Final outcome was evaluated by follow up visits or telephone interview.


RESULTS
Sixty nine patients were included and followed until complete recovery, or for 5 years. Ten per cent were caused by Lyme disease, 17% by virus infection, 4% by other causes and 68% were classified as Bell's palsy. All patients with Lyme facial palsy had additional neurological symptoms, and 87% reported constitutional complaints. The overall final outcome was good with complete recovery in 77%, slight sequelae in 20% and moderate sequelae in 3%. No patients experienced severe sequelae. Two of 28 patients examined with neurography had absent compound muscle action potentials in orbicularis oculi. Both made good recovery with only slight sequelae.


CONCLUSIONS
Peripheral facial palsy is a common disorder with a favourable prognosis. Lyme disease seems to be an infrequent cause of facial palsy in patients without constitutional symptoms or additional neurological findings.
Ljøstad
Unn
U
Dept. of Neurology, Sørlandet Sykehus HF, Kristiansand, 416, 4604 Kristiansand, Norway. unn.ljostad@sshf.no
Økstad
Siri
S
Topstad
Thom
T
Mygland
Ase
A
Monstad
Per
P
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000378:metabolism; D025065:Borrelia burgdorferi / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005158:Facial Paralysis / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons
D000906:Antibodies