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Lyme Disease and other
Infectious / Inflammatory / Metabolic Disorders

Many infectious and inflammatory processes can affect facial nerve function. This occurs either through direct effects on the nerve, or because generalized inflammation causes swelling in the tight bony canal through which the facial nerve runs, “choking” the nerve, and causing it to malfunction. Some diseases affect the facial nerve in well understood ways, and others are poorly understood. Below are outlined some of the diseases whose pathophysiologic effects on the facial nerve are understood.

Lyme Disease
Lyme disease is a spirochetal infection caused by the organism Borrelia Burgdorferi. It is ordinarily transmitted through a deer tick vector, and is recognized by a characteristic “Bull’s Eye” lesion at the site of the tick bite. In the acute phase of the disease, this round red macule with a pale center is classic, though in up to 50% of infected individuals the lesion goes unrecognized or does not develop at all. The second phase of the disease, 3-6 weeks after infection, is characterized by migrating joint pains, fatigue, generalized weakness, and cranial neuropathies. It is during this phase that facial palsy may occur. This can affect one or both sides of the face. It can be isolated, or occur in conjunction with dysfunction of other cranial nerves. A blood test for the detection of Lyme disease is available, and confirmation of the disease requires antibiotic therapy.

Multiple Sclerosis
Multiple Sclerosis (MS) is a demyelinating disease in which the sheaths surrounding myelinated motor nerves are broken down, preventing them from conducting signals appropriately. It can affect any motor nerve, including the facial nerve. It tends to wax and wane substantially, so that nerve function fluctuates according to the activity of the disease. During periods of disease remission, neural function often returns to normal.

Diabetes Mellitus
Diabetes Mellitus (DM) is a lack of internal control over blood sugar levels, based on failure of the islet cells in the pancreas to produce insulin. Blood sugar levels are critical for maintaining proper homeostasis (balance of internal milieu), and lack of proper control over these levels causes many organ systems to develop disease prematurely. Amongst these systems is the nervous system; neuropathies are common in later stages of DM. The facial nerve, like any other nerve, is susceptible to malfunction on the basis of this DM-associated neuropathy.


 

 



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Geographical Risk of Lyme Disease


Geographical Risk of Lyme Disease
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Deer Tick

Deer Tick
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Borrelia Burgdorferi

Borrelia Burgdorferi
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Doxycycline Illustration
Doxycycline