Interesting article on Neuroborreliosis (NeuroLyme) in children

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Uncommon manifestations of neuroborreliosis in children

Baumann M, Birnbacher R, Koch J, Strobl R, Rostásy K.

European Journal of Paediatric Neurology, Volume 14, Issue 3, May 2010,

Pages 274-277.

http://dx.doi.org/10.1016/j.ejpn.2009.08.003

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.

http://dx.doi.org/10.1016/j.ejpn.2009.08.003