Bilateral facial paralysis is an extremely rare clinical entity. It most often appears a special finding in a symptom
complex of a systemic disease; many of them are potentially life-threatening. Failure to diagnose and treat at an early
stage can have adverse clinical outcomes, and therefore clinicians should be aware of the differential diagnosis when
evaluating a case. Lyme disease, Guillain-Barre syndrome, Bell’s palsy, leukemia, sarcoidosis, bacterial menengitis,
syphilis, leprosy, Moebius syndrome, infectious mononucleosis, and skull fracture are the most common causes of
bilateral facial paralysis. A 55 years old man suffering from fatiguability, myalgia and ear pain since one month, has
delivered peripheral facial paralysis after six days in addition to mentioned symptoms first on the right then on the left
side. Specific antibody positivity against Borrelia burgdorferi was measured in the patient’s serum, in addition to a tickbite
history. Our case diagnosed Lyme disease was begun amoxicilline theraphy and in a short-time, his symptoms
relieved. Through this case, we wanted to notice Lyme disease that is one of the causes of bilateral facial paralysis and
to emphasize the necessity to ascertain ‘’ a tick-bite,, history and to search the specific antibodies against Borrelia
burgdorferi in such cases.
Key Words: Bilateral facial paralysis, Lyme disease, Tick-bite, Erythema migrans
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