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[Meningo-encephalomyelitis in Lyme disease]
O Pincemaille1, I Pin, I Wroblewski
1Service de Médecine Infantile, C.H.R.U. de Grenoble.
Archives Francaises De Pediatrie
|January 1, 1990
Summary
This case study details a 13-year-old boy with Lyme disease affecting only the central nervous system. Early diagnosis and treatment with antibiotics led to cerebrospinal fluid improvement, though neurological recovery was slow.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Lyme disease, caused by Borrelia burgdorferi (BB), can manifest with diverse neurological symptoms.
- Central nervous system (CNS) involvement in Lyme disease, known as neuroborreliosis, requires accurate diagnosis and timely management.
Observation:
- A 13-year-old male presented with progressive spastic quadraparesis.
- Cerebrospinal fluid (CSF) analysis revealed chronic lymphocytic meningitis with low glucose.
- Magnetic resonance imaging (MRI) showed demyelinating lesions in the white matter.
Findings:
- Serological tests confirmed high antibody titers against Borrelia burgdorferi in serum and CSF.
- Evidence of a specific intrathecal immune response against BB antigen was identified.
- Diagnosis of isolated CNS Lyme disease was established.
Implications:
- Prompt antibiotic treatment with penicillin G and ceftriaxone improved CSF abnormalities.
- Neurological symptom improvement was gradual, indicating potential long-term effects of neuroborreliosis.
- This case highlights the importance of considering Lyme disease in pediatric CNS disorders.