[Neurologic manifestations of Lyme borreliosis in children]

Since detection of the etiologic agent of Lyme borreliosis a wide spectrum is known to be caused by Borrelia burgdorferi (Bb) including acute, subacute, or chronic central nervous system (CNS) manifestations. In view of the difficulties in interpreting serological results the early diagnosis of Lyme borreliosis sometimes may be problematic. Our own observations in children which suffered from an acute neuroborreliosis (NB) showed the following: 1) Culturing of Bb from cerebrospinal fluid (CSF) seems successful particularly in the early phase of the disease. 2) A positive serum antibody titer cannot confirm, and a negative one cannot exclude a recent NB. 3) Indeed, there is a seronegative NB also in children. 4) A peripheral facial palsy without clinical evidence of meningitis can be the first manifestation of the disease. thus, in any case of peripheral facial palsy even without clinical evidence of meningitis a lumbar puncture has to be done in order to confirm or exclude a CNS infection.