title: Lyme disease with lymphocytic meningitis, trigeminal palsy and silent thalamic lesion.
abstract: We describe a follow-up in a 15-year-old boy with neuroborreliosis diagnosed by clinical symptoms, CSF and serum analysis. MRI revealed a thalamic lesion and an enhancement of the right trigeminal nerve clinically associated with mild hypasthesia in the right maxillary region. Both, clinical symptoms and radiological findings disappeared within 2 months after treatment. Borrelia burgdorferi specific IgM and IgG in CSF and IgG in serum became negative between 6 and 12 months after diagnosis. We show that neuroborreliosis at an early stage may present only with moderate neurological deficits and that at this stage MRI reveals distinct cerebral lesions which might even precede clinical manifestation. Thus, early diagnosis and treatment of neuroborreliosis may prevent persistent neurologic lesions.
authors.affiliation: Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany. koechling@paedia.ukl.mu-luebeck.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Köchling
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Freitag
authors.forename: Thomas
authors.initials: T
authors.lastname: Bollinger
authors.forename: Alexander
authors.initials: A
authors.lastname: Herz
authors.forename: Jürgen
authors.initials: J
authors.lastname: Sperner
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000473:pathology*; D010243:Paralysis / Q000473:pathology; D051299:Post-Dural Puncture Headache / Q000150:complications; D013786:Thalamic Diseases / Q000473:pathology*; D013788:Thalamus / Q000473:pathology; D014276:Trigeminal Nerve / Q000473:pathology; D020433:Trigeminal Nerve Diseases / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents