[Two cases of facial diplegia with elevated serum antibodies to Borrelia burgdorferi].

Lyme disease, a tick-borne infection with spirochete named Borrelia burgdorferi, is a complex multi-organ disorder involving neurological complication. Recently, the existence of Lyme disease was also recognized in middle Japan. We described here two cases of facial diplegia with elevated serum antibodies to B. burgdorferi. Case 1 was a 48 year-old man, who developed facial diplegia on April 29, 1987, and referred to our hospital on May 1. Neurological examination showed facial diplegia in addition to right-sided hemiparesis due to head injury of twenty years ago. The cell count of the cerebrospinal fluid was 17/mm3 and the protein was 139.9 mg/dl. The serological examinations for B. burgdorferi were performed by means of immunoperoxidase test. This patient had no serum IgG antibodies to B. burgdorferi on admission. However, twelve weeks later his serum showed significant elevation of IgG antibodies (titer: X400). Tests for syphilis and leptospira were negative. Based on these observation, we considered that facial diplegia of this patient was associated with the infection of B. burgdorferi. His facial diplegia remained unchanged with oral corticosteroid treatment. Case 2 was a 64 year-old man, who developed facial diplegia on May 31, 1987, and referred to our hospital on June 3. Neurological examinations were entirely negative except for facial diplegia. The findings of the cerebrospinal fluid showed the albumin cytologic dissociation with the cell count 2/mm3 and the protein 85.4 mg/dl. Serum IgG antibodies to B. burgdorferi were present (titer: X200) on admission. However, seven weeks later his serum showed a marked elevation of IgG antibodies (titer: X1600). Tests for syphilis were negative.(ABSTRACT TRUNCATED AT 250 WORDS)