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Outcome of facial palsy from Lyme disease in prospectively followed patients who had received corticosteroids.

Abstract
Although a short course of corticosteroid therapy has been shown to improve the outcome of idiopathic facial nerve palsy (Bell's palsy), it is unclear whether corticosteroids, in addition to antibiotic therapy, are beneficial, are harmful, or have no impact on the outcome of facial palsy from Lyme disease (LDFP). From 2011 through 2016, 14 patients with LDFP were enrolled into a prospective study to determine the outcome of Lyme disease over the ensuing 12 months. Eleven (78.6%) had received corticosteroids in addition to oral antibiotics and entered the study within 24 days after onset of the LDFP (median 14 days, range 2-24 days). Overall, 6 of the corticosteroid-treated patients (54.5%, 95% C.I.: 28.0% to 78.7%) had evidence of residual dysfunction of the facial nerve at the last evaluation, which occurred at a mean of 13.1 months after the baseline visit (range 9.6-19.6 months). In conclusion, although corticosteroids are frequently prescribed for LDFP, the efficacy of this therapy has not been established. Like another recent report, our study raises concern about the safety of adjunctive corticosteroid treatment for LDFP. A well-designed, prospective clinical trial is needed to determine the risk-to-benefit ratio of corticosteroid therapy for LDFP.
AuthorsGary P Wormser, Donna McKenna, Carol Scavarda, Carol Karmen
JournalDiagnostic microbiology and infectious disease (Diagn Microbiol Infect Dis) Vol. 91 Issue 4 Pg. 336-338 (Aug 2018) ISSN: 1879-0070 [Electronic] United States
PMID29720355 (Publication Type: Journal Article)
CopyrightCopyright © 2018 Elsevier Inc. All rights reserved.
Chemical References
  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
Topics
  • Adrenal Cortex Hormones (therapeutic use)
  • Adult
  • Aged
  • Anti-Bacterial Agents (therapeutic use)
  • Drug Therapy, Combination
  • Facial Paralysis (drug therapy, etiology, physiopathology)
  • Female
  • Follow-Up Studies
  • Humans
  • Lyme Disease (complications, drug therapy)
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome

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