Neurologic involvement, also known as Lyme neuroborreliosis, is reported in 5%-20% of cases. In the United States, cranial neuropathy is the most common manifestation of early neurologic Lyme disease. Other manifestations include meningitis and encephalopathy.
Cranial neuropathies, especially facial nerve palsy (Bell palsy), develop in approximately 3% of Lyme disease patients. In endemic areas, Lyme disease is the most commonly identified cause of acquired facial palsy, especially in children. Headache, absence of previous herpetic lesions, and meningeal symptoms are noted in most pediatric Lyme disease patients with facial palsy.
For more on the neurologic manifestations of Lyme disease, read here.
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Cite this: Russell W. Steele. Fast Five Quiz: Can You Identify and Treat Lyme Disease? - Medscape - Jul 15, 2015.