Evidence map›Paper›PMID 39221969›Full record

ArticleActa paediatrica (Oslo, Norway : 1992)2025

Peripheral facial palsy in children: Serum Borrelia antibodies may reduce the need for lumbar puncture.

Joakim Bloch, Lisbeth Schmidt, Nadja Vissing, Alex Christian Yde Nielsen, Jonathan Peter Glenthøj, Birgitte Smith, Jan Gorm Lisby, Lene Nielsen, Malte Tetens, Anne-Mette Lebech and 1 more

Abstract read
In one paragraph

Article in Acta paediatrica (Oslo, Norway : 1992), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Serum Borrelia IgG as a rule-out test in suspected lyme neuroborreliosis: a large retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  2. Lyme borreliosis.Nature reviews. Disease primers · 2026
    Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Joakim BlochDepartment of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.ORCID 0000-0002-9618-3483
Lisbeth SchmidtDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
Nadja VissingDepartment of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Alex Christian Yde NielsenDepartment of Clinical Microbiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Jonathan Peter GlenthøjDepartment of Children and Adolescents, Copenhagen University Hospital - North Zealand Hospital, Hilleroed, Denmark.
Birgitte SmithDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
Jan Gorm LisbyDepartment of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
Lene NielsenDepartment of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
Malte TetensDepartment of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Anne-Mette LebechDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
Ulrikka NygaardDepartment of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Funding

Innovationsfonden 0176-00020BRigshospitalets forskningspuljer
6 · The paper itself

Abstract

aimWe aimed to investigate the causes of acute peripheral facial palsy (PFP) in Danish children and to explore whether neuroborreliosis-related PFP could be diagnosed without lumbar puncture using clinical symptoms and serum Borrelia burgdorferi (Bb) antibodies.

methodsThis retrospective population-based cohort study included children undergoing lumbar puncture for PFP between 2019 and 2023 in Denmark's Capital Region. Diagnostic performance measures for neuroborreliosis-related PFP were compared between serum Bb IgG alone and clinical risk scores combining Bb IgG with clinical parameters.

resultsOf the 326 patients with PFP, 137 (42%) were diagnosed with neuroborreliosis and 151 (46%) had Bell's palsy. Positive predictive value for serum Bb IgG alone was 88% (95% CI 79-93) and negative predictive value was 83% (95% CI 75-88). The positive predictive value of a risk score with seven additional parameters was 90% (95% CI 81-95) and negative predictive value 87% (95% CI 80-92).

conclusionThe positive predictive value of serum Bb IgG alone was high in our setting, where nearly half of children with PFP had neuroborreliosis. In high endemic settings, lumbar punctures may be reduced by (i) treating all children with PFP with doxycycline or (ii) treating Bb IgG positive children and performing lumbar puncture in seronegative children.

Indexed as

Antibodies, BacterialFacial ParalysisLyme NeuroborreliosisSpinal PunctureAdolescentBorrelia burgdorferiChildChild, PreschoolDenmarkFemaleHumansImmunoglobulin GMaleRetrospective StudiesAntibodies, BacterialImmunoglobulin Gborrelia antibodiesBorrelia burgdorferiborrelia serologylumbar punctureneuroborreliosisperipheral facial palsy

Identifiers

PMID39221969
PMCPMC11627444

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.