Lyme disease and facial palsy without pleocytosis

To the Editor: Albisetti et al.1 discussed in detail the diagnostic value of early and convalescent antibody response to Borrelia burgdorferi in serum and CSF of children with peripheral facial palsy (PFP) and suspected Lyme borreliosis. They did not discuss in depth the CSF cell count result. The authors define lymphocytic pleocytosis as a cell count >20 cells/µL, described five children with PFP without lymphocytic pleocytosis, obtained a convalescent phase serum in only one of these five patients, mentioned lymphocytic pleocytosis as a characteristic finding in neuroborreliosis, and ruled out the diagnosis in all five patients. PFP …