Biomaterial Database

Neurologic manifestations in children with Lyme disease. 1995

P M Bingham, and S L Galetta, and B Athreya, and J Sladky

Division of Neurology, Children's Hospital of Philadelphia, PA 19104, USA.

OBJECTIVE Lyme disease (LD) is a tick-borne spirochetal infection with a wide range of neurologic and non-neurologic manifestations. The clinical diversity of LD and limitations in serologic diagnosis often make it difficult to document the diagnosis of neuroborreliosis with certainty. METHODS We reviewed clinical manifestations in 97 seropositive children with particular attention to neurologic manifestations. Diagnostic criteria used in other case surveys were applied to determine how often a definitive diagnosis of neuroborreliosis could be made in children. RESULTS Of 69 children who met criteria for LD, 32% (22) had new neurologic signs, 73% (16) of which were accounted for by facial palsy and aseptic meningitis. Five of those with neurologic findings also had erythema migrans (EM), and one had both EM and arthritis. Among those with neurologic involvement, boys outnumbered girls two to one. Neurologic abnormalities resolved spontaneously in five children before their serologic results were known. CONCLUSIONS In our series, only 27% of children with neurologic abnormalities due to LD had a history of EM or arthritis. Seropositivity commonly constituted the primary basis for diagnosis of LD. Despite its nonspecificity, seropositivity for LD in children with neurologic symptoms usually signifies active neuroborreliosis.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D008193	Lyme Disease	An infectious disease caused by a spirochete, BORRELIA BURGDORFERI, which is transmitted chiefly by Ixodes dammini (see IXODES) and pacificus ticks in the United States and Ixodes ricinis (see IXODES) in Europe. It is a disease with early and late cutaneous manifestations plus involvement of the nervous system, heart, eye, and joints in variable combinations. The disease was formerly known as Lyme arthritis and first discovered at Old Lyme, Connecticut.	Lyme Borreliosis,B. burgdorferi Infection,Borrelia burgdorferi Infection,Lyme Arthritis,Arthritis, Lyme,B. burgdorferi Infections,Borrelia burgdorferi Infections,Borreliosis, Lyme,Disease, Lyme
D008297	Male		Males
D009422	Nervous System Diseases	Diseases of the central and peripheral nervous system. This includes disorders of the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscle.	Neurologic Disorders,Nervous System Disorders,Neurological Disorders,Disease, Nervous System,Diseases, Nervous System,Disorder, Nervous System,Disorder, Neurologic,Disorder, Neurological,Disorders, Nervous System,Disorders, Neurologic,Disorders, Neurological,Nervous System Disease,Nervous System Disorder,Neurologic Disorder,Neurological Disorder
D011115	Polyneuropathies	Diseases of multiple peripheral nerves simultaneously. Polyneuropathies usually are characterized by symmetrical, bilateral distal motor and sensory impairment with a graded increase in severity distally. The pathological processes affecting peripheral nerves include degeneration of the axon, myelin or both. The various forms of polyneuropathy are categorized by the type of nerve affected (e.g., sensory, motor, or autonomic), by the distribution of nerve injury (e.g., distal vs. proximal), by nerve component primarily affected (e.g., demyelinating vs. axonal), by etiology, or by pattern of inheritance.	Polyneuropathy, Acquired,Polyneuropathy, Critical Illness,Polyneuropathy, Familial,Polyneuropathy, Inherited,Polyneuropathy, Motor,Acquired Polyneuropathies,Acquired Polyneuropathy,Critical Illness Polyneuropathies,Critical Illness Polyneuropathy,Familial Polyneuropathies,Familial Polyneuropathy,Inherited Polyneuropathies,Inherited Polyneuropathy,Motor Polyneuropathies,Motor Polyneuropathy,Polyneuropathies, Acquired,Polyneuropathies, Critical Illness,Polyneuropathies, Familial,Polyneuropathies, Inherited,Polyneuropathies, Motor,Polyneuropathy
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D003937	Diagnosis, Differential	Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.	Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005158	Facial Paralysis	Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. FACIAL NERVE DISEASES generally results in generalized hemifacial weakness. NEUROMUSCULAR JUNCTION DISEASES and MUSCULAR DISEASES may also cause facial paralysis or paresis.	Facial Palsy,Hemifacial Paralysis,Facial Palsy, Lower Motor Neuron,Facial Palsy, Upper Motor Neuron,Facial Paralysis, Central,Facial Paralysis, Peripheral,Facial Paresis,Lower Motor Neuron Facial Palsy,Upper Motor Neuron Facial Palsy,Central Facial Paralyses,Central Facial Paralysis,Facial Palsies,Facial Paralyses, Central,Facial Paralyses, Peripheral,Palsies, Facial,Palsy, Facial,Paralyses, Central Facial,Paralyses, Facial,Paralyses, Hemifacial,Paralysis, Central Facial,Paralysis, Facial,Paralysis, Hemifacial,Paralysis, Peripheral Facial,Pareses, Facial,Paresis, Facial,Peripheral Facial Paralysis
D005260	Female		Females