A Longitudinal Cohort Study of Children with Peripheral Facial Nerve Palsy in Lyme Disease Endemic Areas

Sophi R. Lederer; Desiree N. Neville; Fran Balamuth; Laura L. Chapman; Amy D. Thompson; Meagan M. Ladell; Anupam B. Kharbanda; Michael C. Monuteaux; Lise E. Nigrovic

doi:10.1016/j.jpeds.2025.114879

A Longitudinal Cohort Study of Children with Peripheral Facial Nerve Palsy in Lyme Disease Endemic Areas

Sophi R. Lederer
, Desiree N. Neville
, Fran Balamuth
, Laura L. Chapman
, Amy D. Thompson
, Meagan M. Ladell
, Anupam B. Kharbanda
, Michael C. Monuteaux
, Lise E. Nigrovic

Boston Children's Hospital
University of Pittsburgh
The Children's Hospital of Philadelphia
Brown University
Medical College of Wisconsin
Children's Minnesota

Research output: Contribution to journal › Article › peer-review

Abstract

In our longitudinal cohort of 385 children with peripheral facial nerve palsy, 7 of 145 (4.8%; 95% CI 2.4-9.6%) with Lyme disease did not initially receive appropriate antibiotics and 98 of 240 (40.8%; 95% CI 34.8-47.2%) with idiopathic facial palsy received antibiotics unnecessarily. A rapid and accurate Lyme diagnostic could improve initial treatment.

Original language	English
Article number	114879
Pages (from-to)	114879
Journal	Journal of Pediatrics
Volume	289
Early online date	1 Nov 2025
DOIs	https://doi.org/10.1016/j.jpeds.2025.114879
State	Published - Feb 2026

Keywords

antibiotics
Bell palsy
corticosteroids
facial palsy
idiopathic facial palsy
Lyme disease
peripheral facial nerve palsy

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10.1016/j.jpeds.2025.114879

Cite this

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title = "A Longitudinal Cohort Study of Children with Peripheral Facial Nerve Palsy in Lyme Disease Endemic Areas",

abstract = "In our longitudinal cohort of 385 children with peripheral facial nerve palsy, 7 of 145 (4.8\%; 95\% CI 2.4-9.6\%) with Lyme disease did not initially receive appropriate antibiotics and 98 of 240 (40.8\%; 95\% CI 34.8-47.2\%) with idiopathic facial palsy received antibiotics unnecessarily. A rapid and accurate Lyme diagnostic could improve initial treatment.",

keywords = "antibiotics, Bell palsy, corticosteroids, facial palsy, idiopathic facial palsy, Lyme disease, peripheral facial nerve palsy",

author = "Lederer, \{Sophi R.\} and Neville, \{Desiree N.\} and Fran Balamuth and Chapman, \{Laura L.\} and Thompson, \{Amy D.\} and Ladell, \{Meagan M.\} and Kharbanda, \{Anupam B.\} and Monuteaux, \{Michael C.\} and Nigrovic, \{Lise E.\}",

year = "2026",

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doi = "10.1016/j.jpeds.2025.114879",

language = "English",

volume = "289",

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journal = "Journal of Pediatrics",

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T1 - A Longitudinal Cohort Study of Children with Peripheral Facial Nerve Palsy in Lyme Disease Endemic Areas

AU - Lederer, Sophi R.

AU - Neville, Desiree N.

AU - Balamuth, Fran

AU - Chapman, Laura L.

AU - Thompson, Amy D.

AU - Ladell, Meagan M.

AU - Kharbanda, Anupam B.

AU - Monuteaux, Michael C.

AU - Nigrovic, Lise E.

PY - 2026/2

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N2 - In our longitudinal cohort of 385 children with peripheral facial nerve palsy, 7 of 145 (4.8%; 95% CI 2.4-9.6%) with Lyme disease did not initially receive appropriate antibiotics and 98 of 240 (40.8%; 95% CI 34.8-47.2%) with idiopathic facial palsy received antibiotics unnecessarily. A rapid and accurate Lyme diagnostic could improve initial treatment.

AB - In our longitudinal cohort of 385 children with peripheral facial nerve palsy, 7 of 145 (4.8%; 95% CI 2.4-9.6%) with Lyme disease did not initially receive appropriate antibiotics and 98 of 240 (40.8%; 95% CI 34.8-47.2%) with idiopathic facial palsy received antibiotics unnecessarily. A rapid and accurate Lyme diagnostic could improve initial treatment.

KW - antibiotics

KW - Bell palsy

KW - corticosteroids

KW - facial palsy

KW - idiopathic facial palsy

KW - Lyme disease

KW - peripheral facial nerve palsy

UR - https://www.scopus.com/pages/publications/105023579367

U2 - 10.1016/j.jpeds.2025.114879

DO - 10.1016/j.jpeds.2025.114879

M3 - Article

C2 - 41177400

AN - SCOPUS:105023579367

SN - 0022-3476

VL - 289

SP - 114879

JO - Journal of Pediatrics

JF - Journal of Pediatrics

M1 - 114879

ER -

A Longitudinal Cohort Study of Children with Peripheral Facial Nerve Palsy in Lyme Disease Endemic Areas

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Keywords

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