Involvement of Borrelia burgdorferi in cranial nerve affection.

From January 1984 to August 1985 54 patients presented with cranial nerve lesions at the neurological department of the University hospital Innsbruck. Median age was 42 years, range 5-81 years. Female male ratio was 49/15. In 17 patients cranial neuritis was consistent with meningopolyneuritis Bannwarth (MPN) in 37 cases mere facial palsy was present. Cranial neuritis in MPN-patients affected N. facilis in 10, N. opticus and N. oculo-motorius in one case each. Five patients had polyneuritis cranialis with affection of the cranial nerves II, V, VI, VII, VIII, and IX (Table 1). IgG-antibodies to B. burgdorferi were found in the sera of all MPN patients and in 15 of cases with mere facial palsy. Patients with antibodies to B. burgdorferi were treated with intravenous penicillin and latamoxef dinatrium. The remaining 22 patients were treated with vitamin B compound and corticosteroids. The time for full recovery was 4 weeks on the average in each treatment group.