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Arch Pediatr Adolesc Med. 1998;152:928-929.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Belman et al¹ do not report whether the accepted confirmatory serologic test for Lyme disease, the serum immunoblot,² was performed on their patients. It is well established that enzyme-linked immunosorbent assay (ELISA) methods for total antibodies to Borrelia burgdorferi have a high false-positive rate. No cerebrospinal fluid assay, other than culture for B burgdorferi or polymerase chain reaction (PCR) for B burgdorferi DNA, is accepted as specific. Thus, Lyme disease was not confirmed in their patients and several or all may have had idiopathic Bell palsy.

The diagnosis of recent or current B burgdorferi infection in a patient with acute facial palsy can be made by performing serum IgM immunoblotting during the acute phase (4 weeks after the onset of infection), which helps in making the decision to initiate early antibiotic treatment.³ Demonstration of seroconversion by IgG immunoblot in the convalescent period is confirmatory.

Sunil K. Sood, MD
Pediatric . . . [Full Text of this Article]

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