Primarily chronic and cerebrovascular course of Lyme neuroborreliosis: case reports and literature review.

Kinderklinik der Georg-August- Universitat, Abteilung Kinderheilkunde, Schwerpunkt Neuropadiatrie, Robert-Koch-Strabetae 40, 37075 Gottingen, Germany.
Archives of Disease in Childhood (Impact Factor: 2.91). 08/2000; 83(1):67-71.
Source: PubMed

ABSTRACT As part of an ongoing study aiming to define the clinical spectrum of neuroborreliosis in childhood, we have identified four patients with unusual clinical manifestations. Two patients suffered from a primarily chronic form of neuroborreliosis and displayed only non-specific symptoms. An 11 year old boy presented with long standing symptoms of severe weight loss and chronic headache, while the other patient had pre-existing mental and motor retardation and developed seizures and failure to thrive. Two further children who presented with acute hemiparesis as a result of cerebral ischaemic infarction had a cerebrovascular course of neuroborreliosis. One was a 15 year old girl; the other, a 5 year old boy, is to our knowledge the youngest patient described with this course of illness. Following adequate antibiotic treatment, all patients showed substantial improvement of their respective symptoms. Laboratory and magnetic resonance imaging findings as well as clinical course are discussed and the relevant literature is reviewed.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Numerous improvements have been made along the years in the prevention, diagnosis and treatment of Lyme borreliosis (LB). Nonetheless, LB remains the most common human infection transmitted by ticks in temperate regions of the northern hemisphere [1,2]. Lyme borreliosis is a multisystemic infection caused by the pathogenic genospecies of the Borrelia burgdorferi sensu lato (s.l.) complex, including B. burgdorferi sensu stricto (s.s.), Borrelia garinii, Borrelia afzelii, Borrelia bavariensis, and Borrelia spielmanii. All pathogenic genospecies can cause erythema migrans (EM), which is the classical target rash that is cha - racteristic of Lyme disease but distinct genospecies possess diferent organotropism, and may prefe - rentially cause distinct clinical manifestations of LB. B. burgdorferi s.s. is most commonly associated with arthritis, B. garinii with neuroborreliosis, and B. afzelii with cutaneous manifestations of LB (EM, lymphocytoma borreliosis, and acrodermatitis chronica atrophicans) [3]. B. burgdorferi s.s. and B. afzelii may also be associated with neurological manifestations, but at a lower rate than that of B. garinii [4-6]. Approximately 60% of patients with EM, treated with antibiotics, have long or short episodes of arthritis caused by B. burgdorferi s.s in North America [7]. By contrast, only 3-15% of patients with LB suffer from arthritis in Europe [8], where B. garinii and B. afzelii are the most commonly found genospecies. The average Lyme borreliosis annual incidence is 37.77, the ma ximum being registered in Slovenia, and the mi - nimum value in Ireland (0.6) [9]. In some geo graphical regions it has had an increase in the rates of disease transmission and in the incidence implicitly [10], so that LB should continue to be regarded as an emerging disease. In Romania, according to data reported by the National Center for Surveillance and Control of Communicable Diseases (CNSCBT) of the National Institute of Pu - blic Health (INSP), both institutions under the coordination of the Ministry of Health, the incidence of LB in 2011 was 2/100,000. B. burgdorferi sensu lato (s.l.) genospecies circulating in Romania are: B. burgdorferi s.s., B. afzelii and B. garinii [11].
    Roumanian archives of microbiology and immunology 06/2013; 72(2):135-63.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the relationship of endolymphatic hydrops to Ménière's disease. Comprehensive review of articles from 1938 through 2012 via Medline and Index Medicus. Articles discussing Ménière's disease and/or endolymphatic hydrops that include temporal bone autopsy data. Fifty-three case reports and series were studied containing examination of 541 hydropic temporal bones and including 276 patients with Ménière's disease. These were divided into those meeting the 1995 American Academy of Otolaryngology-Head and Neck Surgery criteria for Ménière's disease and those that failed to meet these criteria. An individual meeting the 1995 criteria for Ménière's disease has a near certain probability of having endolymphatic hydrops in at least 1 ear. Autopsy data do not support the view that the association of MD and EH is an epiphenomenon or that MD causes EH; this leaves us with the probability that EH causes MD. If it is causative, hydrops alone is insufficient to cause Ménière's disease, indicating that there must be one or more additional cofactors that cause asymptomatic hydrops to become symptomatic Ménière's disease. Vascular risk factors should be studied as possible cofactors.
    Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 08/2013; · 1.44 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lyme disease is associated with various systemic and neurological manifestations. The neurological and psychiatric manifestations of Lyme disease are more frequently observed during its secondary phase (stage 2) than during its late tertiary phase (stage 3). In stage 2, cerebrospinal fluid and bacterial tests are consistent with the ongoing infection. Painful meningoradiculitis, encephalomyelitis and encephalitis, and symptoms of depression are the most characteristic at this stage. The diagnosis should be based on the association of clinical, epidemiological, and biological features. Adequate treatment usually leads to recovery. In stage 3 of the disease, the link between neurological manifestations and initial infection is uncertain. Distal axonal polyneuropathy and chronic encephalopathy are the most frequently reported presentations.
    Médecine et Maladies Infectieuses 07/2007; 37(7):532-539. · 0.91 Impact Factor


Available from