Fast Five Quiz: Bell Palsy and Other Facial Paralysis

Helmi L. Lutsep, MD


February 27, 2020

Of patients affected with Lyme disease, 10% develop facial paralysis, with 25% of these patients presenting with bilateral palsy. In endemic areas, Lyme disease is the most commonly identified cause of acquired facial palsy, especially in children.

Although facial palsies may resolve without treatment, oral antibiotic therapy may prevent further sequelae. Neurologic Lyme disease is effectively treated with a 2-week course of parenteral penicillin, ceftriaxone, or cefotaxime. Oral doxycycline is as efficacious as parenteral antibiotic therapy in patients who have Lyme disease–associated meningitis, facial nerve palsy, or radiculitis.

Read more about Lyme disease.


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