SEROLOGICAL EVIDENCE OF BORRELIA BURGDORFERI INFECTION IN MEXICAN PATIENTS WITH FACIAL PALSY

Background: Facial palsy is the most frequent manifestation of neuroborreliosis in the United States, Europe, and Asia, whereas in Mexico, its frequency is unknown. Objective: We aimed to determine the frequency of Borrelia spp. infection in patients with acute facial palsy in Mexico. Materials and Methods: In this cross-sectional, referral hospital-based survey, 191 patients with facial palsy were selected and clinical and epidemiologic data recorded. IgM and IgG serum antibodies to Borrelia burgdorferi were tested by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western-Blot (WB). IgM and IgG antibodies against the herpes viruses HSV-1, HSV-2, cytomegalovirus, and Epstein-Barr virus were tested by ELISA. Results: 71 patients (37%) tested positive by ELISA to either Borrelia spp. or the herpes viruses. Of 25 patients (13%) who tested positive for B. burgdorferi by ELISA, 23 (12%) were confirmed by WB; 14 had IgM and 9 had IgG antibodies. Among the 14 IgM-WB positive patients, two cases recognized antigens of B. burgdorferi sensu stricto (s.s.), 10 of Borrelia garinii and 2 of B. afzelii, whereas all 9 IgG-WB positive were reactive against B. burgdorferi s.s. 14 patients had facial palsy in addition to other clinical data compatible with Lyme borreliosis. Patients infected with B. burgdorferi s.s. had a longer recovery time and a significantly higher risk (odds ratio 4.4, 95% confidence interval 1.5-12.9) of recurrent facial palsy than patients infected with other Borrelia genospecies. Conclusions: Borrelia infection is frequent in facial palsy patients in Mexico, with B. burgdorferi s.s. and B. garinii being the most frequent causative species.