Journal Article

Successful Oral Doxycycline Treatment of Lyme Disease-Associated Facial Palsy and Meningitis

Leif Dotevall and Lars Hagberg

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 3, pages 569-574
Published in print March 1999 | ISSN: 1058-4838
Published online March 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515145
Successful Oral Doxycycline Treatment of Lyme Disease-Associated Facial Palsy and Meningitis

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Twenty-nine patients, aged 11–79 years (mean, 50 years), with Lyme neuroborreliosis, facial nerve palsy, and meningitis were treated with oral doxycycline (daily dose, 200–400 mg) for 9–17 days in a prospective, nonrandomized study. Facial paresis was bilateral in eight (28%) of the 29 patients. Twenty-six patients (90%) recovered without sequelae within 6 months, while three of the patients with bilateral facial palsy at admission had remaining paresis at follow-up. In five patients, contralateral facial paresis developed 1–12 days after initiation of therapy, and two patients were retreated with antibiotics. Posttreatment examinations of cerebrospinal fluid showed a marked decrease of inflammatory cells and protein concentrations compared with pretreatment levels in all followed up patients. The favorable clinical outcome agrees with findings of other reports on intravenous antibiotic therapy for Lyme disease-associated meningitis with facial palsy. Our conclusion is that oral doxycycline is an effective and convenient therapy for Lyme disease-associated facial palsy.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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