title: [Facial diplegia as the presenting feature of Lyme disease].
abstract: BACKGROUND
  Diagnosis of neuroborreliosis may be difficult. Neuroborreliosis mainly results in lymphocytic meningitis and in meningoradiculitis (67-83% of cases).
  
  
  METHODS
  We report the case of a patient who developed a sudden facial diplegia, revealing neuroborreliosis proved by positive blood and cerebrospinal fluid serology. The patient had no previous history of tick bite and migrans erythema. The patient was given ceftriaxone therapy (2 g/day for 21 days), leading to resolution of all clinical symptoms.
  
  
  CONCLUSIONS
  Our report underscores that neuroborreliosis should be considered in patients exhibiting facial diplegia. Thus, Lyme serology should be performed systematically in these patients. Altogether, early management is crucial, before the onset of neurological manifestations at late stage, leading to disabling sequelae despite antibiotic therapy.
authors.affiliation: Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Lesourd
authors.affiliation: Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Ngo
authors.affiliation: Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Sauvêtre
authors.affiliation: Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Héron
authors.affiliation: Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Levesque
authors.affiliation: Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France. Electronic address: isabelle.marie@chu-rouen.fr.
authors.forename: I
authors.initials: I
authors.lastname: Marie
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005158:Facial Paralysis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D020852:Lyme Neuroborreliosis / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009128:Muscle Spasticity
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone
keywords: Atteinte neurologique; Diplégie faciale; Facial diplegia; Lyme's disease; Maladie de Lyme; Neuroborreliosis; Neuroborréliose; Neurologic impairment