Anti-Borrelia burgdorferi antibodies in patients with facial paralysis.

Ninety-eight patients with facial paralysis were studied by an indirect enzyme-linked immunosorbent assay (ELISA) employing two types of Borrelia burgdorferi antigen, namely sonic extract and flagellum protein of B. burgdorferi. IgG or IgM antibodies were detected by sonic extract ELISA in 22 (32.4%) of 68 patients with Bell's palsy, and in 2 (10.0%) of 20 patients with varicella-zoster virus infection. This difference was statistically significant (P < 0.05). A positive reaction was more frequent with the sonic extract antigen, while the positive rates were significantly increased in Bell's palsy patients with hyperglobulinemia (P < 0.05). IgM antibodies were also significantly more frequently observed in patients who developed Bell's palsy between October and March (P < 0.05). Since none of the patients had a history suggestive of Lyme disease, some kind of non-specific reaction and certain undefined factors linked to a positive reaction against B. burgdorferi could be involved in Bell's palsy.