Uncommon manifestations of neuroborreliosis in children |
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| Authors: | Matthias Baumann Robert Birnbacher Johannes Koch Robert Strobl Kevin Rostásy |
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| Institution: | 1. Department of Pediatrics, Division of Pediatric Neurology and Inherited Metabolic Disorders, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria;2. Department of Pediatrics, General Hospital Villach, Austria;3. Department of Pediatrics, University Children''s Hospital, Paracelsus Private Medical University Salzburg, Austria;4. Department of Pediatrics, General Hospital Lienz, Austria;1. Division of Neuroradiology, Department of Radiology, Paracelsus Medical University Salzburg, Austria Ignaz-Harrer-Strasse 79, A-5020 Salzburg, Austria;2. Department of Neurology, Paracelsus Medical University Salzburg, Austria Paracelsus Medical University Salzburg, Austria Ignaz-Harrer-Strasse 79, A-5020 Salzburg, Austria;3. Department of Neurosurgery, Paracelsus Medical University Salzburg, Austria Ignaz-Harrer-Strasse 79, A-5020 Salzburg, Austria;1. Department of Anaesthesia and Intensive Care, Evangelical Hospital Vienna, Austria;2. Department of General and Surgical Critical Care Medicine, Medical University Innsbruck, Austria;3. Institute of Anaesthesiology, University and University Hospital Zurich, Switzerland;4. Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Germany;1. Christian Doppler Laboratory for Immunomodulation, Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria;2. Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria;3. Biomay AG, Vienna, Austria;4. Allergy Clinic Reumannplatz, Vienna, Austria;5. Thermo Fisher Scientific, Uppsala, Sweden;1. Clinical Department of General and Transplant Surgery, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria;2. Clinical Division of Hematology & Oncology, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria;3. Clinical Division of Gastroenterology & Hepatology, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria;4. Central Institute for Blood Transfusion and Immunological Department, General Hospital and Medical University of Innsbruck, Innsbruck, Austria;1. Swiss Tropical and Public Health Institute, Basel, Switzerland;2. Clinic of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland;3. Division of Hematology, University Hospital Basel, Basel, Switzerland;4. Department of Dermatology, University Hospital Basel, Basel, Switzerland |
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| Abstract: | Lyme borreliosis is a tick-borne spirochetal infection which affects the skin, joints, heart and nervous system. Children with a neuroborreliosis usually present with a facial nerve palsy or aseptic meningitis, but the spectrum also includes other rare manifestations. We report four unusual cases of childhood neuroborreliosis and show that seizures with regional leptomeningeal enhancement, acute transverse myelitis, meningoradiculitis with pain and paraesthesia and cranial nerve palsies other than facial nerve palsy can be the leading symptoms of children with neuroborreliosis. All children had serological evidence of an acute infection with Borrelia burgdorferi, a pleocytosis in the cerebrospinal fluid and a complete response to antibiotic treatment. An intrathecal synthesis of IgG antibodies was detected in three children. Thus, diagnostic work up in children with unusual neurological symptoms should include cerebrospinal fluid studies with determination of the white blood cell count and calculation of the antibody index against B. burgdorferi. |
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