https://danielcameronmd.com/bells-palsy-can-lead-to-nonflaccid-facial-palsy/
Bell’s palsy typically presents as flaccid facial palsy, where one or both sides of the face drops. However, Bell’s palsy can also lead to nonflaccid facial palsy. Lyme disease can cause either flaccid or nonflaccid facial palsy (NFFP).
There is a broad range of findings. “Nonflaccid facial paralysis is a spectrum of hypokinetic and hyperkinetic movement,” writes Markey and colleagues in the journal Otolaryngology.¹
Hypokinetic movement involves less movement, while hyperkinetic movement involves more movement.
“Clinically, this manifests as contraction of the orbicularis oris muscle simultaneous with eye closure or blinking and/or contraction of the orbicularis oculi during speaking or chewing,” explains Rubin in the Handbook of Clinical Neurology.² Orbicularis oris muscles are the group of muscles in the lips that encircles the mouth.
“Patients affected by NFFP often have a narrowed palpebral fissure, prominent and misoriented nasolabial fold, neck and face tightness, and mentalis dimpling,” writes Miller and colleagues in the journal Facial Plastic Surgery & Aesthetic Medicine.³ “These muscles can make a smile asymmetry.”
Lyme disease can cause either flaccid or nonflaccid facial palsy. CLICK TO TWEET
A narrowed palpebral fissure is a narrowing of the eye opening between the eyelids. Mentalis are the chin muscles.
Bell’s palsy can lead to NFFP in 15–30% of patients, writes Miller. “Other common causes of NFFP include Ramsay Hunt syndrome, acoustic neuroma resection, Lyme disease, trauma, autoimmune disease.”
Patients can suffer from NFFP with significant functional, aesthetic, psychological, and social impairments,” writes Miller.
To view photos of patients with both flaccid and nonflaccid facial palsy, visit “The spectrum of facial palsy: The MEEI facial palsy photo and video standard set.”
Treatment of nonflaccid facial palsy
There is a wide range of treatments for NFFP including:
Editor’s note: I have treated Lyme disease patients in my practice with nonflaccid facial palsy and have seen first hand the “significant functional, aesthetic, psychological, and social impairments” it can cause, as described by Miller.
Treatment varies for Bell’s palsy in children with Lyme disease
Steroids harmful to patients with Bell’s palsy caused by Lyme disease
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**Comment**
The most important treatment NOT mentioned is anti-microbial treatment for Lyme disease.
In my experience, symptoms go away or lessen considerably with antimicrobial treatment. From personal experience I can tell you I would have wasted a lot of money and time had I tried to treat each symptom with adjunctive therapies. Of course if the symptom is debilitating it would probably be worth it, but many symptoms come and go throughout treatment, but good, effective antimicrobial treatment has always been and will always be where you should spend your money first.
https://danielcameronmd.com/what-nesting-songbirds-tell-us-about-lyme-disease-in-canada/
There are Canadian residents who develop Lyme disease without having ever left the country. So, how are they contracting the disease? Researchers have shown that migratory birds can carry ticks into Canada from other regions.
But now, a new study reports that nesting songbirds may confirm what Canadians have long believed – Borrelia burgdorferi-infected deer ticks have already established residency in Canada.
“We estimate that migratory birds disperse 50 million to 175 million I. scapularis [deer] ticks across Canada each spring, implicating migratory birds as possibly significant in I. scapularis range expansion in Canada,” writes Ogen and colleagues.¹
A study by Scott et al., however, finds that migratory songbirds, specifically, can disperse ticks into “new areas hundreds of kilometers away from their original source.”²
“This indicates that many I. scapularis-carrying migratory birds in spring have destinations far north in Canada, including some farther north than the current region of climatic suitability for I. scapularis,” the authors write.
Scott and colleagues studied nesting songbirds to determine whether established populations of deer ticks existed in Canada since nesting birds stay in close proximity to their nest in June and July.
READ MORE: Lack of knowledge about Lyme disease in Canada
“Short runs ensure that the eggs in the nest stay warm and protected from predators,” Scott writes in the article, “Monitoring of Nesting Songbirds Detects Established Population of Blacklegged Ticks and Associated Lyme Disease Endemic Area in Canada.”
“Additionally, during the fledging period, ground-foraging songbirds make hasty flights near the nest, and promptly return to feed their young,” Scott writes.
A new study looking at nesting songbirds finds established deer tick populations in Canada. CLICK TO TWEET
Researchers looked at deer ticks collected from nesting songbirds. To demonstrate an established population, they needed to find 6 individual ticks from a specific area. Moreover, they needed to find ticks from 2 of the 3 life stages (i.e., larva, nymph, and adult).
They found 63 black-legged [deer] nymphal ticks and 1 black-legged larval tick. In addition, they found 2 life stages from a single bird within a single year. One was a larva tick and two were nympal ticks.
Nearly half of the deer ticks collected were infected with Borrelia burgdorferi s.s., the causative agent of Lyme disease. According to the authors, “14 (42%) of 33 of black-legged tick nymphs tested were positive.”
The author’s approach was novel. Over a two-month period, they could pinpoint an established population of ticks.
The authors made three recommendations
Hot spots for blacklegged ticks found in Canada
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**Comment**
This study once again shows ticks don’t need any help from the climate to travel. They just hop on the backs of birds, rodents, and lizards and go wherever they go.
As to seeking medical attention after obtaining a tick bite – this is great advice but not all practitioners appreciate the seriousness of infection and very well might tell you to “wait and see.” This “wait and see” advice has been the downfall of many patients who could have avoided long-term illness had they treated prophylactically.
For more: https://www.ilads.org/research-literature/lyme-disease-basics-for-providers/
Excerpt:
Evidence indicates that 20 days of prophylactic antibiotic treatment may be highly effective for preventing the onset of Lyme disease after known Ixodes tick bite. Patients with early Lyme disease may be best served by receiving 4-6 weeks of antibiotic therapy. Cases of chronic B. burgdorferi infection require individualized treatment plans.
Black-legged Tick Bite
Dr. Bransfield discusses the similarities and differences between the two pandemics of Lyme Disease and COVID-19, with a particular emphasis on their neuropsychiatric manifestations. Viral infections have been associated with mood changes, psychosis, changes in neuromuscular function and even demyelinating processes, as has Lyme Disease, particularly neuroborreliosis. He examins the connections, such as they are known to date, and answers questions live during the webinar.
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**Comment**
If you are unfamiliar with Dr. Bransfield, you are in for a treat. He is one of the few psychiatrists who studies the psychiatric effects of Lyme/MSIDS.
For more: https://madisonarealymesupportgroup.com/2018/04/15/ld-the-brain-podcast-with-dr-bransfield/
https://madisonarealymesupportgroup.com/2017/06/20/suicide-lyme-and-associated-diseases/
https://madisonarealymesupportgroup.com/2017/01/17/lymemsids-and-psychiatric-illness/
Approx. 1 Hour
In this episode you will learn three main things:
1) Why you should consider a functional medicine doctor for your Lyme Journey
2) Why you should never accept a psychiatric diagnosis from an endocrinologist
3) How allowing “the bottom to fall out” gives you the opportunity to find out what is important in your life
Stephanie Silverberg got acutely sick about three years ago. Neurological symptoms progressed to the point where she was bed bound for three months. Consultations with specialists didn’t yield any results, and it wasn’t until she visited a functional medicine doctor that she was able to start to regain her health and begin her lyme journey. She works as a marriage counselor in Ohio.
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For More: https://madisonarealymesupportgroup.com/2020/04/17/whats-a-lyme-patient-to-do-when-fear-hits/
https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/
https://madisonarealymesupportgroup.com/2017/11/01/lyme-mental-illness-dr-jane-marke/
