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Date of last update: 10/04/2017.

Forum Name: Neurology Topics

Question: Duration of facial paralysis from Lyme Disease

 Daisy83 - Wed Oct 28, 2009 10:20 am

Hello Folks,

I am a 61-year-old female, recovering from Lyme Disease. On August 3, 2008, I was sent to the emergency room because half my face was paralyzed. A week later, the other side was also paralyzed. In November, a positive diagnosis of Lyme Disease was made after a lumbar puncture, with the assumption that it had begun in April, 2008. I had a course of doxycycline and have been improving ever since. I have just received the results from the fourth lumbar puncture, with negative results for all Lyme bacteria.
However, I still have some paralysis left, although I can now eat and drink and both eyes almost close. It's been over a year since the paralysis began, what are the chances for complete recovery?

Thank you.
 Dr.M.Aroon kamath - Fri Dec 04, 2009 9:09 pm

User avatar Hi,
Unilateral and bilateral facial paralysis may occur in up to 11% of patients with Lyme disease.

It has been recommended that Lyme disease etiology must be considered in all otherwise idiopathic facial paralyses , especially when presenting in summer months in endemic areas, or when bilateral.

In Lyme disease, encephalitis is triggered and that this inflammation not only causes imbalances in numerous neurotransmitters, it also causes vasculitis which leads to hypoperfusion and hypoxia of the brain and in nerves.

This aseptic meningitis and Bell's palsy tend to occur within the
first few months following the tick bite, but may also occur as
part of reactivation disease.

For Lyme disease facial palsy, infectious disease experts recommend antibiotic therapy (although considerable controversy still exists as to the need for oral versus parenteral antibiotic therapy). Reactivation of the disease also occassionally occurs resulting in a facial palsy months after first episode.

As for your question as to when your facial palsyis likely to recover, unfortunately i am unable to give a straight answer as studies on this particular aspect are far and few.

It is may not be too scientific to extrapolate the recovery patterns in Bell's palsy to recovery of facial palsy in Lyme disease.However, this may give you some idea as to what to expect.

Approximately 50% of Bells Palsies will have essentially complete recoveries in a short time (Generally the regeneration of nerves will be complete within three months after onset). Another 35% will have good recoveries in less than a year.
The nerve can continue to regenerate for about 18 months, probably even longer. Improvement of appearance can continue even beyond that time frame.

Best wishes!

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