Updated December 29, 2014.

This patient with facial palsy caused by an infection with the bacterial spirochete Borrelia burgdorferi was diagnosed with Lyme disease. In addition to multiple (secondary) erythema migrans lesions, an early disseminated Lyme disease infection may manifest itself as a disease of the nervous system, the musculoskeletal system, or the heart. Neuropathologic manifestations include lymphocytic meningitis, cranial neuropathy (especially facial nerve palsy) and radiculoneuritis.