{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T22:50:18Z","timestamp":1699829418991},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Pediatric bilateral facial nerve paralysis (FNP) is a rare condition, representing less than 2% of all cases of FNP. The differential diagnosis of FNP is extensive (ranging from infectious, traumatic, neurologic, to idiopathic) and often can present as a diagnostic challenge. In contrast to unilateral presentation, bilateral FNP presents as a manifestation of serious systemic conditions, including meningitis (infectious and neoplastic), brain stem encephalitis, Guillain-Barre syndrome, sarcoidosis, Lyme disease, human immunodeficiency virus infection, leukemia, and vasculitis. In the evaluation of a child who presents with bilateral FNP, history plays the utmost role in the diagnosis. A history of rash consistent with erythema chronicum migrans, recent tick exposure, or travel to a Lyme disease\u2013endemic area is highly suggestive that the facial paralysis is a result of Lyme disease. It is also important to recognize that Lyme disease is emerging as the most common infectious etiology of bilateral FNP in the pediatric population. In this case report, we describe a 16-year-old boy who presented to the emergency department with complaints of headache and bilateral FNP, an unusual presentation of Lyme disease.<\/jats:p>","DOI":"10.1097\/pec.0000000000001648","type":"journal-article","created":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T22:12:14Z","timestamp":1540591934000},"page":"e651-e653","source":"Crossref","is-referenced-by-count":3,"title":["Pediatric Bilateral Facial Paralysis"],"prefix":"10.1097","volume":"36","author":[{"given":"Kei","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Section of Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Sequeira","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Bechtel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Emergency Medicine, Section of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2018,10,26]]},"reference":[{"key":"bib1-20230930","first-page":"458371","article-title":"Bilateral facial nerve palsy: a diagnostic dilemma","volume":"2012","year":"2012","journal-title":"Case Rep Emerg Med"},{"issue":"4 Pt 1","key":"bib2-20230930","first-page":"519","article-title":"Pediatric bilateral facial paralysis","volume":"108","year":"1998","journal-title":"Laryngoscope"},{"key":"bib3-20230930","first-page":"4521526","article-title":"Bilateral facial diplegia: a rare presenting symptom of Lyme","volume":"2017","year":"2017","journal-title":"Case Rep Infect Dis"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1097\/PRS.0000000000002599","article-title":"Bilateral facial paralysis: a 13-year experience","volume":"138","year":"2016","journal-title":"Plast Reconstr Surg"},{"key":"bib5-20230930","first-page":"572","article-title":"Acute onset of facial nerve palsy associated with Lyme disease in a 6 year-old child","volume":"24","year":"2002","journal-title":"Pediatr Dent"},{"key":"bib6-20230930","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0385-8146(02)00147-5","article-title":"Pediatric bilateral facial nerve palsy secondary to acute otitis media","volume":"30","year":"2003","journal-title":"Auris Nasus Larynx"},{"key":"bib7-20230930","first-page":"29","article-title":"Lyme disease\u2014United States, 2000","volume":"51","year":"2002","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bib8-20230930","doi-asserted-by":"crossref","first-page":"321","DOI":"10.2310\/8000.2011.110512","article-title":"Bell palsy in Lyme disease\u2013endemic regions of Canada: a cautionary case of occult bilateral peripheral facial nerve palsy due to Lyme disease","volume":"14","year":"2012","journal-title":"CJEM"},{"key":"bib9-20230930","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s002340050675","article-title":"Lyme disease in a child presenting with bilateral facial nerve palsy: MRI findings and review of the literature","volume":"40","year":"1998","journal-title":"Neuroradiology"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"973","DOI":"10.12998\/wjcc.v3.i12.973","article-title":"Facial nerve paralysis in children","volume":"3","year":"2015","journal-title":"World J Clin Cases"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001648","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:30:23Z","timestamp":1696062623000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001648"}},"subtitle":["An Unusual Presentation of Lyme Disease"],"short-title":[],"issued":{"date-parts":[[2018,10,26]]},"references-count":10,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001648","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2018,10,26]]}}}