Visualize waking up and finding that one side of your face is frozen– the smile drooping, eyes not blinking, and you are just left to wonder what has happened.
For individuals with Lyme disease, this is not just a symptom– it is facial paralysis or Lyme- induced Bell’s palsy.
Why does it happen in some cases, while others won’t experience it?
What actually causes the loss of muscle control?
And most importantly, can it be reversed?
Let’s uncover the science behind the symptoms and the hope behind the healing.
Why Lyme disease causes Facial Paralysis?
Borrelia burgdorferi bacteria is the causative agent of Lyme disease. After transmission by a tick bite, it circulates through the host's body and lymphatic systems.
It might as well breach the blood brain barriers via paracellular or transcellular mechanisms. Thereby gaining access to the central and peripheral nervous system.
Once it is inside the neural tissue, it triggers a localized immune response, releasing pro- inflammatory cytokines and chemokines.
In Lyme Neuroborreliosis:
Facial palsy is one of the hallmark manifestations, if at all, it affects the facial nerve.
The infection strikes and compromises barrier integrity, elevates permeability and furthermore facilitates the entry of the bacterial and inflammatory cells to neural tissue.
The inflammatory swelling within the nerve can result in acute facial weakness or Paralysis like condition. Link
Will Facial Movement Return?
Key Factors Affecting Recovery:
1.Timing of Treatment
Antibiotic intervention during the early period of Lyme disease will yield better outcomes and prognosis. According to reports, treatment initiated within 30 days of the onset will lead to 15-20% lingering symptoms, compared to 35-40% of the treatment when delayed. (Link).
2.Unilateral vs. Bilateral Palsy
There is no significant difference in the recovery speed or completeness between unilateral and bilateral cases, as reported. (Link)
3.Use of Corticosteroids
The use of steroids along with antibiotics made no significant difference in improving the outcome or recovery time. (Link).
4.Age Group
As compared to adults, children have 80-75% full recovery over a long- term period. Whereas 23% of the cases of the adults would still have residual symptoms or lingering symptoms. (Link)
Real stories from Lyme warriors
1. Tami Fitzgerald (Cleveland Clinic story)
- In early 2021, Tami—then 63 and recovering from COVID—developed severe facial paralysis after a tick bite led to Lyme disease complicated by encephalitis and meningitis (Cleveland Clinic).
- Despite antibiotics resolving most systemic issues, her facial nerve remained paralyzed. She underwent reconstructive surgeries and ongoing physical therapy under specialized care.
- Today, Tami can smile, close her eyes, and eat with ease—a transformation she credits to perseverance and expert intervention (Cleveland Clinic).
2. “Lyme + Bell’s Palsy” Reddit Story
One user recounted the shock of suddenly developing bilateral facial paralysis after beginning
doxycycline:
“Lyme disease, first bells‑palsy then bilateral…, then lyme disease…” (Reddit)
Another shared:
“After 5 days of doxy I woke up with facial paralysis.” (Reddit)
These reflect the unpredictable timing and profound anxiety of Lyme-related facial palsy—but also show that treatment can follow swiftly.
3. Janet (Facial Palsy U.K.)
- Suffering chronic Lyme, Janet faced permanent facial palsy with synkinesis—twitching and tight muscle movements—after years of struggle (Facial Palsy UK).
- With extended antibiotic therapy (7 months), MRI monitoring, facial exercises, and targeted Botox, she began to reclaim facial mobility—allowing her to smile again, though reminders of her journey remain (Facial Palsy UK).
