• Sigurdur Arnason, Malou Hultcrantz, Anna Nilsson, and Åsa Laestadius.
• Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
• Acta Paediatr. 2020 Jun 1; 109 (6): 1229-1235.

AimTo identify the incidence, aetiology and prognosis of acute peripheral facial nerve palsy (FNP) in children in the Borrelia high-endemic region of Stockholm.MethodsThe present study identified children from 0 to 18 years of age who visited a paediatric emergency department for acute peripheral FNP during a 1-year period from 2014 to 2015. Data were collected retrospectively. The Sunnybrook and House-Brackmann facial grading systems were used to measure clinical outcome.ResultsA total of 77 children were identified with FNP, an estimated incidence of 30 per 100 000 children/year. Forty-five children (58%) were diagnosed with neuroborreliosis, 28 (36%) with idiopathic FNP and four (6%) with other rarer causes. Neuroborreliosis was common from June to November and mainly seen in children below 10 years of age. Six patients (8%) had remaining symptoms at least 3 months after onset; three had idiopathic facial palsy (IFP) and were all older than 10 years, one had neuroborreliosis and two had other causes.ConclusionNeuroborreliosis and IFP were the major causes of FNP during the study period. Neuroborreliosis-associated facial palsy had a seasonal variation and dominated in younger ages.© 2019 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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