title: Stroke-like Phenomena Revealing Multifocal Cerebral Vasculitis in Pediatric Lyme Neuroborreliosis.
abstract: Stroke-like presentation in Lyme neuroborreliosis is rare in the pediatric age group. We report a previously healthy 12-year-old boy who presented with acute left hemiparesis and meningeal signs. Neuroimaging failed to reveal any cerebral infarction but demonstrated a multifocal cerebral vasculitis involving small, medium and large-sized vessels affecting both the anterior and posterior circulation. Concentric contrast enhancement of the basilar artery was also observed. Further investigations and laboratory findings were consistent with Lyme neuroborreliosis. A rapidly favorable clinical outcome was obtained with appropriate antibiotic treatment along with antiaggregants and steroids. Lyme neuroborreliosis should be considered in the diagnostic differential, not only in adults but also among children, especially in the context of an unexplained cerebral vasculitis.
authors.affiliation: Pediatric Neurology, Pediatric Subspecialties Service, Children's Hospital, Geneva, Switzerland mary.kurian@hcuge.ch.
authors.forename: Mary
authors.initials: M
authors.lastname: Kurian
authors.affiliation: Neuroradiology Unit, University Hospitals, Geneva, Switzerland.
authors.forename: Vitor Mendes
authors.initials: VM
authors.lastname: Pereira
authors.affiliation: Neuroradiology Unit, University Hospitals, Geneva, Switzerland.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Vargas
authors.affiliation: Pediatric Neurology, Pediatric Subspecialties Service, Children's Hospital, Geneva, Switzerland.
authors.forename: Joel
authors.initials: J
authors.lastname: Fluss
mesh_terms: D002648:Child; D006801:Humans; D021621:Imaging, Three-Dimensional; D020852:Lyme Neuroborreliosis / Q000150:complications*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000209:etiology*
keywords: lyme; neuroborreliosis; pediatric; stroke; stroke-like; vasculitis