CNS Lyme disease manifestation in children.
BACKGROUND
Neurological symptoms develop in 10-20% of children with borreliosis.


OBJECTIVE
It was a presentation of clinical manifestation of neuroborreliosis in children.


METHODS
Children with neuroborreliosis and other neurological diseases were admitted to the University Hospital during 2005-2006 without any selection. Of these 9 patients, there were seven males and two females, ranging in age between 3-17 years. Neurological diagnostic was performed using ELISA Biomedica kit and western blot bands. A 2-6 week sequential treatment with either i.v. ceftazidime or amoxicillin and oral doxycycline or amoxicillin was provided. Children were monitored regularly during the next 4-24 months.


RESULTS
The 9 children with borreliosis constitute 0.53% of the pediatric neurology department's patients. The clinical manifestation of LD were usual and unusual from patient to patient. They included three cases of facial nerve paralysis (with bilateral paralysis in one case). In two cases, they included transverse myelitis and in a single case, hemiparesis, meningitis and acute ataxia. Typically, other patients with early stage borreliosis first manifest focal seizures, raising the suspicion that borreliosis could be responsible for triggering seizures. The antibiotic treatment was successful in 7 patients and only partially effective in 2 children with facial nerve paralysis.


CONCLUSIONS
The most common symptom of neuroborreliosis in children is motor dysfunction. Acute ataxia may be a clinical presentation of neuroborreliosis. It is probable that borreliosis_triggers seizures in children with EEG abnormalities.
Kaciński
Marek
M
Department of Pediatric Neurology, Jagiellonian University, Krakow, Poland. neupedkr@cm-uj.krakow.pl
Zajac
Anna
A
Skowronek-Bała
Barbara
B
Kroczka
Sławomir
S
Gergont
Aleksandra
A
Kubik
Alicja
A
D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015153:Blotting, Western; D002442:Ceftazidime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D010243:Paralysis / Q000209:etiology; D012640:Seizures / Q000209:etiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D002442:Ceftazidime