Un petit tour et puis revient…

Lyme neuroborreliosis is estimated to cause 2 to 25% of peripheral facial palsy. We report a 46-year-old man, which presented a right and, 14 days later, a left facial palsy. There is no tick bite or erythema migrans rash. Lymphocytic meningitis was present with positive serology in CSF and blood. He recovered without sequelae with treatment by ceftriaxone. A bilateral facial nerve palsy and/or neurological symptoms outside the affected area of the face, must decided to explore CSF, and a mononuclear pleiocytosis in the CSF, in an endemic area, could be the reason to start a treatment, without final serologic diagnosis made by positive anti-borrelia antibody index.