All Posts Tagged With: "meningeal signs"

Excerpt:

89 cases of neuroborreliosis were reported; in 66 cases diagnosis was confirmed. Facial weakness was one of the presenting symptoms in 47 cases (71%) and the only symptom in nine children (14%). The five complaints most frequently reported were: malaise, headache, fatigue, fever and neck pain. 52 children (79%) had one or more objective neurological signs at presentation, of which facial nerve palsy, other cranial nerve abnormalities and meningeal signs were most frequent. 14 patients (21%), however, had no neurological signs at physical examination. In these patients, the number of subjective complaints was higher, and the time interval to diagnosis was longer compared with those with objective neurological abnormalities.

Conclusions

In this study, 79% of paediatric neuroborreliosis patients presented with neurological signs, most often facial nerve palsy. 21% presented in an atypical way without neurological signs. A thorough neurological examination is essential once neuroborreliosis is considered in children. Even in the absence of neurological signs, neuroborreliosis may be suspected in children with typical antecedents and multiple symptoms. Cerebrospinal fluid investigations are then required to confirm the diagnosis.

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.