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[33] [34] The likelihood that the facial palsy is caused by Lyme disease should be estimated based on the recent history of outdoor activities in likely tick habitats during warmer months, a recent history of rash or symptoms such as headache and fever, and whether the palsy affects both sides of the face (much more common in Lyme disease than in Bell's palsy)

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Finally, remodeling occurs as initial scar tissue reorganizes into functional tissue aligned with mechanical demands