Olsson I, Engervall K, Asbrink E, Carlsson-Nordlander B, Hovmark A
Department of Dermatology, Södersjukhuset, Stockholm, Sweden.
Acta Otolaryngol. 1988 Jan-Feb;105(1-2):100-7. doi: 10.3109/00016488809119451.
During a one-year period, 82 consecutive patients seeking medical attention for facial palsy primarily of unknown etiology were examined for underlying Ixodes ricinus-borne borreliosis. Evidence of the infection was found in 16 (20%) of the patients, most of whom had cerebrospinal fluid findings indicating meningeal involvement. Among 9 children included in the study, borreliosis was found in 6 cases. Bilateral facial palsy occurred in 3 of the borrelia-infected patients, as compared with none of the patients without borreliosis. It is suggested that, in areas where the tick vector is present, borreliosis should be regularly sought in patients with facial palsy of otherwise unknown etiology. As regards the serological diagnosis, it is emphasized that normal borrelia antibody titres in serum and cerebrospinal fluid at the time of the first consultation do not exclude the infection. A careful serological follow-up of patients with facial palsy is therefore recommended in order not to miss an underlying borreliosis which, if allowed to go untreated, implies a risk of other organ involvement and a protracted course.
在为期一年的时间里，对82例主要因病因不明前来就医的面瘫患者进行了潜在的蓖麻硬蜱传播的疏螺旋体病检查。在16例（20%）患者中发现了感染证据，其中大多数患者的脑脊液检查结果显示有脑膜受累。在该研究纳入的9名儿童中，6例发现患有疏螺旋体病。疏螺旋体感染患者中有3例出现双侧面瘫，而未感染疏螺旋体病的患者中无一例出现双侧面瘫。建议在存在蜱传播媒介的地区，对于病因不明的面瘫患者应定期排查疏螺旋体病。关于血清学诊断，需要强调的是，初次就诊时血清和脑脊液中疏螺旋体抗体滴度正常并不能排除感染。因此，建议对面瘫患者进行仔细的血清学随访，以免漏诊潜在的疏螺旋体病，若不治疗，该病可能会累及其他器官并导致病程迁延。
