Steroid use in Lyme disease ‐associated facial palsy is associated with worse long‐term outcomes

ConclusionAn association between corticosteroid use in acute LDFP and worse long‐term facial function outcomes has been demonstrated. Care should be taken in differentiating viral or idiopathic facial palsy (e.g., Bell palsy) from LDFP. Level of Evidence4. Laryngoscope, 2016
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: General Otolaryngology Source Type: research

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We present the case of a 10-year old patient from southeastern Ontario with severe bilateral facial palsy. MRI was performed that showed extensive symmetric enhancement of cervical cranial nerve roots and multiple cranial nerves (III, V, VI, VII, VIII, X and XII). Lumbar puncture was performed that revealed pleocytosis and elevated proteins in the cerebrospinal fluid. Serology confirmed the diagnosis of neuroborreliosis. The patient was treated with a 4-week course of IV ceftriaxone, following which he returned to baseline.
Source: IDCases - Category: Infectious Diseases Source Type: research
Although a short course of corticosteroid therapy has been shown to improve the outcome of idiopathic facial nerve palsy (Bell's palsy), it is unclear whether corticosteroids, in addition to antibiotic therapy, are beneficial, harmful or have no impact on the outcome of facial palsy from Lyme disease (LDFP). From 2011 through 2016, 14 patients with LDFP were enrolled into a prospective study to determine the outcome of Lyme disease over the ensuing 12months. Eleven (78.6%) had received corticosteroids in addition to oral antibiotics and entered the study within 24days after onset of the LDFP (median 14days, range 2 –24days).
Source: Diagnostic Microbiology and Infectious Disease - Category: Microbiology Authors: Source Type: research
Authors: Sekelj A, Đanić D Abstract Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes si...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
​BY ANUMEHA SINGH, MD, &ANDREJ KIELTYKA, PASymptomatic bradycardia is usually reserved for the over-the-hill crowd, but it is not entirely unheard of in the young and healthy. A 21-year-old African American man was sent to the emergency department by his primary care provider. The patient had no previous medical issues, normal vital signs, and was fine until about a week prior. He had quickly worsening shortness of breath while climbing the stairs to get to his dorm bedroom. The young man denied having been out in the woods or noting tick bites. He had no family history of cardiomyopathy or early cardiac events.​Th...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
The facial paralysis and drooping is caused by nerve inflammation, but the cause of that inflammation “ is a question for the ages ” says one expert.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Immune System Bell's Palsy Herpes Viruses Steroids Lyme Disease Nerves and Nervous System Source Type: news
This report highlights the continuing public health challenge of Lyme disease in states with high incidence and demonstrates its emergence in neighboring states that previously experienced few cases. Educational efforts should be directed accordingly to facilitate prevention, early diagnosis, and appropriate treatment. As Lyme disease emerges in neighboring states, clinical suspicion of Lyme disease in a patient should be based on local experience rather than incidence cutoffs used for surveillance purposes. A diagnosis of Lyme disease should be considered in patients with compatible clinical signs and a history of potenti...
Source: MMWR Surveill Summ - Category: Epidemiology Authors: Tags: MMWR Surveill Summ Source Type: research
is the most common tick-borne illness in the USA and Europe. Pathogens involved are Borrelia burgdorferi in the USA and B. afzelii and B. garinii in Europe. The characteristic rash of erythema migrans occurs in approximately 75% of patients. Neurological disease, including facial palsy, meningoencephalitis, aseptic meningitis and polyradiculopathy, occurs in 10 –15%. Cardiac disease, primarily manifest as heart block, is seen in 1–2%. Arthritis is seen as a late complication in about 30%.
Source: Medicine - Category: Internal Medicine Authors: Tags: Bacterial infections Source Type: research
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Case Report Source Type: research
Conclusions:An emerging condition, acute opthalmoparesis without ataxia and/or areflexia, was described in a handful of publications as "atypical MFS.4" The diagnostic criteria include acute onset of opthalmoplegia, presence of anti GQ1B IgG, and exclusion of other causes3. Other neurological symptoms such as blepharoptosis, bilateral facial paresis, and oropharyngeal palsy have been demonstrated with this condition.4 IVIG and plasmapharesis are not yet a well established treatment5. The diagnosis of acute opthalmoparesis without ataxia and/or areflexia underscores the vast clinical presentations associated with ...
Source: Neurology - Category: Neurology Authors: Tags: General Neurology: Inflammation, Infections, and Autoimmunity Source Type: research
Conclusions:Diagnostic approach to bilateral FNP should evaluate for: traumatic (skull fractures), infectious (classically Lyme disease), metabolic (diabetes), autoimmune (sarcoidosis, Guillain-Barré syndrome), congenital (Moebius syndrome) and neoplastic (brainstem tumors) entities. WM is a rare cause, a condition due to low-grade B cell lymphoma where lymphoplasmacytoid cells infiltrate different tissues and secrete monoclonal IgM. Peripheral neuropathy develops in 15–30% of the cases, usually a chronic, progressive, symmetric, predominantly distal polyneuropathy. Facial nerve impairment is unusual, caused b...
Source: Neurology - Category: Neurology Authors: Tags: Neuro-oncology: Brain and CNS Metastases Source Type: research
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