Correspondence

Facial Palsy in Lyme Disease

N Engl J Med 1993; 328:1571May 27, 1993

Article

To the Editor:

In Images in Clinical Medicine, Klempner and Molloy (Dec. 17 issue)1 showed a young man with Lyme disease who had erythema chronicum migrans and “Bell's palsy.” The term “Bell's palsy,” from the Scottish anatomist and surgeon,2 is reserved for an idiopathic lower-motor-nerve lesion (“peripheral”) of the seventh cranial nerve3. Lower-motor-nerve facial palsies are a common manifestation of Lyme disease, with a presumed pathophysiology intimately related to the infection itself; therefore, the use of “Bell's palsy” in this setting is incorrect. Rather, this manifestation should merely be referred to as a lower-motor facial paresis associated with Lyme disease, thus reserving “Bell's palsy” for facial paresis of truly unknown cause.

Eric R. Eggenberger, D.O.
Johns Hopkins Hospitals, Baltimore, MD 21287

3 References

1. 1

   Klempner MS, Molloy PJ. Lyme disease. N Engl J Med 1992;327:1793-1793
   Full Text | Web of Science

2. 2

   Bell C. On the nerves of the face, being a second paper on that subject. Phil Trans 1829;111:317-330
   CrossRef

3. 3

   Diseases of the cranial nerves. In: Adams RD, Victor M. Principles of neurology. 4th ed. New York: McGraw-Hill, 1989:1081-3.
   

Citing Articles (1)

Citing Articles

1. 1

   Amy A. Pruitt. (1998) INFECTIONS OF THE NERVOUS SYSTEM. Neurologic Clinics 16:2, 419-447
   CrossRef