Introduction and aim Lyme borreliosis is the most common tick-transmitted disease. It is characterized by three stages, which makes neuroborreliosis second so-called early disseminated stage. In numerous cases peripheral facial palsy is the only symptom and sign of neuroborreliosis. In endemic areas of borreliosis, every acute peripheral facial palsy indicates serological processing and implies a special approach to disease. There is a several predictors of peripheral facial palsy. They are showing us a possible etiology, therapy and prognosis of peripheral facial palsy. Whereas, there is a suspision that the treatment of peripheral facial palsy is more difficult and takes longer, including numerous sequaelae, purpose of research is finding and confirming the value of acoustic reflex and House Brackmann rating skale as prognostic indicators that will make therapy direction and rehab easier and more precise. In the final part of the study, testing to seropositivity will be done on population of Brodsko- Posavska county. Patients and methods Research included 176 patients with acute peripheral facial palsy who were after serological processing divided in three basic groups - borreliosis, Bell's palsy and peripheral facial palsy caused by HSV1 virus. Preliminary audiometry with timpanometry and acoustic reflexes was done on each patient, and a current condition of peripheral facial palsy was rated according to House Brackmann rating scale and photographed. The same testing was implemented in three other measurements - in 3., 6. and 12. week since hospitalization. Repeated serology was not implemented. Protocol criteria was in accordance with exclusion from the study. Every patient had given their consent to be included in research. Survival analysis will be used for data processing, one-way and two-way, analysis of variance, Chi- Square test, Fisher exact test, Kruskal Wallis test, Pearson Point-biserial correlation coefficient and Spearman's rank correlation coefficient. 93 Results In this research acoustic reflex and House Brackmann rating skale are being observed as predictors of peripheral facial palsy in neuroborreliosis. 35 out 176 patients with peripheral facial palsy had borreliosis, which makes incidence of peripheral facial palsy in borreliosis 19,88 %. The research of predictor function of acoustic reflex shows results of comparison of leason location for 4 measurement spots according to diagnosis. In each timepoint patients with diagnosis of Lyme disease had statistically significantly the biggest percentage of suprastapedial lesions, especially in the third week since hospitalization (mostly occurance of paralysis as well) (p < 0,001), as well as in measuring that occured later, all the way to the end of study in the 12. week since paralysis occurance (p = 0,001). Comparing to the time needed to recover, result of analysis shows how group of patients with Lyme disease took the longest to recover (p < 0,001). Among the patients with borreliosis, a bit more than half of them had recovered until the sixth week, while the most patients with Bell's paralysis had already recovered until the third week, and most of the patients with HSV1 did not even have suprastapedijalnu lesion in the first measurement whatsoever. 47% of patients with borreliosis recovered only in the 12. week comparing to Bell's paralysis and patients with HSV1. Testing predictor function of House Brakmann rating scale, patients from all three groups had similar average results on HB scale in the first and the last measurement. However, result on the scale was falling much slower for patients with borreliosis. Comparing the speed of recovery it was shown that there are significant differences in time before until the patient had recovered, or in other words the patient had result 1 on HB scale depending on diagnosis (p < 0,001). Patients with Lyme disease diagnosis took longer to recover than patients with Bell's paralysis and HSV1: more than half of patients with borreliosis had not recovered until the 12. week or did not recover at all during the research while most of the patients with Bell's paralysis and HSV1 had already recovered in the 3. week since occurance of palsy. In additional analysis there was confirmed that all of the patients (100 %) with HSV1 who had suprastapedial lesion in the first measurement were exposed to hypothermia, which confirms the suspision related to etiology, vasospasm or reactivation of the virus. In comparison to acoustic reflex and House Brackmann rating scale, the biggest difference in the classification of the patients was that House Brackmann scale comparing to acoustic reflex shows gradual subsequent recovery. Testing feeling as prodromal sign of peripheral facial palsy in neuroborrealiosis, bigger number of the patients with Lyme disease had headache comparing to other two diagnosis. There were not found any statistically significant differences in recovery cochleostapedial reflex and recovery of facial nerve according to House Breckamm skale that was related to the therapy. At the end, conducting evaluation of seropositivity of the population of Brodsko- posavska county, it was confirmed seroprevalence with borreliosis of 22%, which makes this region a possible endemic area. Conclusion Conducting this research it was proven that cochlostapedial reflex and House Brackmann scale are valuable prognostic indicators of peripheral facial palsy in patients with neuroborreliosis.
