Akut periferik fasyal paralizili olguların Lyme hastalığı açısından incelenmesi

Amaç: Akut periferik fasyal paralizinin etyolojisindeBorrela burgdorferi’nin etken olup olmadığı arafltır ı l d ı .Hastalar ve Yöntemler: Çalıflmaya akut periferik fasyal paralizili 19 hasta alındı. Tüm olgularda rutin KBBmuayenesinin ardından, tat, Schirmer ve stapedialrefleks testleri ile paralizinin derecesi değerlendirildi.Tüm hastalarda rutin biyokimyasal incelemeler yapıldı; serum reaktif protein, romatoid faktör düzeyleri ve sedimantasyon hızları belirlendi. Hastalardanalınan venöz kan örneklerinde ELISA yöntemiyleBorrelia burgdorferi için IgM ve IgG antikorları arafltırıldı.Bulgular: On iki hastada %63.2 sağ, yedisinde %36.8 sol akut periferik fasyal paralizi belirlendi;hiçbirinde iki taraflı paralizi yoktu. Hiçbir serumdaBorrelia burgdorferi için IgM ve IgG seropozitifliğinerastlanmadı.Sonuç: Yüksek derecede endemik bölgelerde, periferik fasyal paralizi ile baflvuran hastalarda, Lymehastalığını saptamak ya da dıfllamak için hasta serumlarının incelenmesi yararlı olabilir

An investigation of patients with acute peripheral facial palsy with regard to Lyme disease

Objectives: We investigated the role of Borrelia burgdorferi in the etiology of idiopathic acute periph­ eral facial palsy.Patients and Methods: Nineteen patients 15 females, 4 males; mean age 38 years; range 14 to 61 years with acute peripheral facial palsy were studied.Following routine otolaryngologic examination, ali the patients undervvent taste, Schirmer, and stapedial reflex tests to evaluate the level of the palsy.Laboratory examination included routine biochemistry analysis, serum C-reactive protein, rheumatoid factor, and erythrocyte sedimentation rate. M i-B o rre lia burgdorferi IgM and IgG antibodies were sought by ELISA in venous blood samples.Results: Of the patient group, acute facial palsy was localized on the right in 12 patients 63.2% , and on the left in seven patients 36.8% . None of the patients had bilateral involvement. No IgM or IgG seropositivity for Borrelia burgdorferi was detected in the serum samples.Conclusion: İn highly endemic areas, it maybe helpful to detect or even to eliminate Lyme disease through screening of serum in patients with acute peripheral palsy.

___

  • Roob G, Fazekas F, Hartung HP. Peripheral facial palsy: etiology, diagnosis and treatment. Eur Neurol 1999;41:3-9.
  • Jonsson L, Stiernstedt G, Thomander L. Tick-borne Borrelia infection in patients with Bell’s palsy. Arch Otolaryngol Head Neck Surg 1987;113:303-6.
  • Furuta Y, Kawabata H, Ohtani F, Watanabe H. Western blot analysis for diagnosis of Lyme disease in acute facial palsy. Laryngoscope 2001;111(4 Pt 1):719-23.
  • Furuta Y, Fukuda S, Chida E, Takasu T, Ohtani F, Inuyama Y, et al. Reactivation of herpes simplex virus type 1 in patients with Bell’s palsy. J Med Virol 1998; 54:162-6.
  • Furuta Y, Ohtani F, Kawabata H, Fukuda S, Bergstrom T. High prevalence of varicella-zoster virus reactiva- tion in herpes simplex viru s - s e ronegative patients with acute peripheral facial palsy. Clin Infect Dis 2000; 30:529-33.
  • M o rgan M, Nathwani D. Facial palsy and infec- tion: the unfolding story. Clin Infect Dis 1992;14: 263-71. [Abstract]
  • Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell palsy and herpes simplex virus: iden- tification of viral DNA in endoneurial fluid and muscle. Ann Intern Med 1996;124(1 Pt 1):27-30. [Abstract]
  • Grandsaerd MJ, Meulenbroeks AA. Lyme borreliosis as a cause of facial palsy during pregnancy. Eur J Obstet Gynecol Reprod Biol 2000;91:99-101.
  • Lotric-Furlan S, Cimperman J, Maraspin V, Ruzic- Sabljic E, Logar M, Jurca T, et al. Lyme borreliosis and peripheral facial palsy. Wien Klin Wochenschr 1999; 111:970-5.
  • Faul JL, Ruoss S, Doyle RL, Kao PN. Diaphragmatic paralysis due to Lyme disease. Eur Respir J 1999;13: 700-2.
  • Clark JR, Carlson RD, Sasaki CT, Pachner AR, Steere AC. Facial paralysis in Lyme disease. Laryngoscope 1985;95:1341-5.
  • Dotevall L, Hagberg L. Successful oral doxycycline treatment of Lyme disease-associated facial palsy and meningitis. Clin Infect Dis 1999;28:569-74.
  • Jonsson L, Stiernstedt G, Carlson J, Stro m b e rg A, Sjoberg O, Larsson A. Serum and cere b rospinal fluid examina- tions in the diagnosis of Borrelia infection in Bell’s palsy. Acta Otolaryngol 1990;110:421-6. [Abstract]
  • Halperin JJ, Golightly M. Lyme borreliosis in Bell’s p a l s y. Long Island Neuro b o r reliosis Collaborative Study Group. Neurology 1992;42:1268-70.
  • Olsson I, Engervall K, Asbrink E, Carlsson-Nordlander B, Hovmark A. Tick-borne borreliosis and facial palsy. Acta Otolaryngol 1988;105:100-7.
  • Pachner AR, Steere AC. The triad of neurologic mani- festations of Lyme disease: meningitis, cranial neuritis, and radiculoneuritis. Neurology 1985;35:47-53.
  • Gökfidan S. Osmaniye bölgesinde artritli asemptoma- tik populasyonda B. burgdorferi prevalansının ELISA ve IHA teknikleri ile arafltırılması [Doktora tezi]. Ç u k u rova Üniversitesi Sağlık Bilimleri Enstitüsü; Adana: 1992.
  • Mutlu G, Gültekin M, Ergin Ç, Sayın F, Kurflun RE. Antalya yöresinde Borrelia burgdoferi antikorlarının ve vektörlerinin arafltırılması. Mikrobiyoloji Bülteni 1995;29:1-6.
  • Erensoy A, Seyrek A, Yılmaz M, Aflçı Z, Kizirgil A. Ela- zığ yöresinde Borrelia burgdoferi antikorlarının arafltı- rılması. Optimal Tıp Dergisi 1997;10:53-6.
  • Christen HJ, Bartlau N, Hanefeld F, Eiffert H, Thomssen R. Peripheral facial palsy in childhood- Lyme borreliosis to be suspected unless proven other- wise. Acta Paediatr Scand 1990;79:1219-24.
  • 1 . Jain VK, Hilton E, Maytal J, Dorante G, Ilowite NT, Sood SK. Immunoglobulin M immunoblot for diag- nosis of Borrelia burgdorferi infection in patients with acute facial palsy. J Clin Microbiol 1996;34: 2 0 3 3 - 5 .