To the Editor—In an Archives article, Bomholt1 described four patients with facial palsies associated with Bannwarth's syndrome. The advances of research in this disease encouraged us to make the following comments.
The isolation of spirochetes from the cerebrospinal fluid (CSF) of a patient with Bannwarth's syndrome by our group2 and the demonstration of antibodies against spirochetes in serum and CSF of patients with Bannwarth's syndrome2,3 clarified the cause of this disease. Bannwarth's syndrome is a tick-borne bacterial disease caused by Borrelia burgdorferi, which is known to be the etiologic agent of the very similar Lyme disease.4,5 Therefore, the viral etiology assumed by Bannwarth6 and cited by Bomholt1 is disproved.
Despite Bomholt's suggestion, the prognosis of patients with Bannwarth's syndrome is not, on the basis of our data, always favorable. We observed 60 patients with serologically proved Bannwarth's syndrome (indirect immunofluorescence against B burgdorferi), 33