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Tick-borne encephalitis (TBE) in a 6 week old infant

By Linda on Jul 7, 2010 in Infections | comments(0)

Full article: https://www.thieme-connect.com/ejournals/abstract/neuropediatrics/doi/10.1055/s-2004-819478

Excerpt:

Case report: A 6-week-old girl developed fever, irritability, meningeal signs with bulging fontanelle and a partial, secondary-generalized seizure. CSF yielded pleocytosis (172 lymphocytes, 81 mono-cytes/ul) and elevated protein (0,83g/l), cranial MRI showed encephalitic signs in both frontal and parietal lobes. Because of a tick bite in an endemic area 10 days before admission, ELISA-IgG and IgM to TBE-virus were sought and found in serum, whereas Borrelia burgdorferi serology, Herpes-simplex virus PCR and bacterial CSF-culture were negative. Phenobarbitone was administered because of repetitive seizures, while the EEG showed series of sharp waves in the right parieto-temporal region. She consecutively became seizure free. At first follow-up after 6 weeks she demonstrated pathologic neurological signs with increased muscular tone, hyperreflexia, fidgety movements, and EEG showed slow waves in the right parieto-temporal region.

Tags: Borrelia burgdorferi serology, cranial MRI, CSF, EEG], ELISA-IgG and IgM, fidgety movements, fulging fontanelle, Herpes-simplex virus, hyperreflexia, immunization, increased muscular tone, meningeal signs, Phenobarbitone, seizures, TBE, tick-borne encephalitis, vaccinations

Lyme Encephalopathy

By Linda on Nov 29, 2009 in Infections | comments(0)

Encephalopathy is like fine art: Most people know it when they see it, but there is very little agreement on how to define it. At the 14th International Lyme Disease Conference, Brian A. Fallon, MD,[1] of Columbia University and the New York State Psychiatric Institute, New York, NY, tried to do just that. More importantly, he described the different ways one can define encephalopathy, the strengths and limitations of each approach, and significantly, what other aspects of life can give the impression of encephalopathy where none exists. First, one must evaluate patients with persistent Lyme encephalopathy by asking the following questions:

Is the diagnosis correct?
Are there comorbid psychiatric disorders that could be treated better? Does the patient have a psychogenic medical illness? What was the patient’s response to prior antibiotics?
Was previous treatment adequate? How long was the course, and what was the route of administration? Was there a subsequent relapse Continued

Tags: abnormal brain scans, arthralgias, arthritis, borrelia burgdorferi, Brian A. Fallon, central nervous system, cerebrospinal fluid, cognitive deficits, cognitive testing, comorbid psychiatric disorders, concentration difficulties, confusion, cranial (facial) neuropathy, cranial nerve palsy, CSF, culture, Depression, DNA, EEG], electroencephalogram, encephalopathy, Erythema migrans, extraneural symptoms, fatigue, headache), IgG., International Lyme Disease Conference, intrathecal antibody, intrathecal antibody production, irritability, knee pain, Logigian, memory, memory loss, meningitis, mood disturbance, MRI, multifocal EM, myalgia, myalgias, neurocognitive impairment, neurologic abnormalities, oligoclonal bands, PCR, pleocytosis, polymerase chain reaction, protein, psychogenic medical illness, radiculoneuritis, single EM; cranial nerve palsy, single photon emission computed tomography, sleep disturbance, sleep problems, SPECT, stiff neck, stroke, tests, tomography, verbal fluency, WBC, word-finding difficulties

Lyme Encepalopathy

By Linda on Nov 29, 2009 in Infections | comments(0)

Encephalopathy is like fine art: Most people know it when they see it, but there is very little agreement on how to define it. At the 14th International Lyme Disease Conference, Brian A. Fallon, MD,[1] of Columbia University and the New York State Psychiatric Institute, New York, NY, tried to do just that. More importantly, he described the different ways one can define encephalopathy, the strengths and limitations of each approach, and significantly, what other aspects of life can give the impression of encephalopathy where none exists.
First, one must evaluate patients with persistent Lyme encephalopathy by asking the following questions:

Is the diagnosis correct?
Are there comorbid psychiatric disorders that could be treated better? Does the patient have a psychogenic medical illness? What was the patient’s response to prior antibiotics?
Was previous treatment adequate? How long was the course, and what was the route of administration? Was there a subsequent relapse Continued

Tags: abnormal brain scans, arthralgias, arthritis, borrelia burgdorferi, Brian A. Fallon, central nervous system, cerebrospinal fluid, cognitive deficits, cognitive testing, comorbid psychiatric disorders, concentration difficulties, confusion, cranial (facial) neuropathy, cranial nerve palsy, CSF, culture, Depression, DNA, EEG], electroencephalogram, encephalopathy, Erythema migrans, extraneural symptoms, fatigue, headache), IgG., International Lyme Disease Conference, intrathecal antibody, intrathecal antibody production, irritability, knee pain, Logigian, memory, memory loss, meningitis, mood disturbance, MRI, multifocal EM, myalgia, myalgias, neurocognitive impairment, neurologic abnormalities, oligoclonal bands, PCR, pleocytosis, polymerase chain reaction, protein, psychogenic medical illness, radiculoneuritis, single EM; cranial nerve palsy, single photon emission computed tomography, sleep disturbance, sleep problems, SPECT, stiff neck, stroke, tests, tomography, verbal fluency, WBC, word-finding difficulties

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