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Lyme neuroborreliosis in children: a prospective study of clinical features, prognosis, and outcome.
Pediatr Infect Dis J. 2008 Dec; 27(12):1089-94.PI

Abstract

BACKGROUND

Evaluation of children with clinically suspected neuroborreliosis (NB) is difficult. With a prospective study design we wanted to characterize children with signs and symptoms indicative for NB, investigate clinical outcome and, if possible, identify factors of importance for recovery.

MATERIAL/METHODS

Children being evaluated for NB (n = 177) in southeast Sweden were categorized into 3 groups: "confirmed neuroborreliosis" (41%) with Borrelia antibodies in the cerebrospinal fluid, "possible neuroborreliosis" (26%) with pleocytosis but no Borrelia antibodies in the cerebrospinal fluid, and "not determined" (33%) with no pleocytosis and no Borrelia antibodies in the cerebrospinal fluid. Antibiotic treatment was given to 69% of children. Patients were followed during 6 months and compared with a matched control group (n = 174).

RESULTS

Clinical recovery at the 6-month follow-up (n = 177) was generally good and no patient was found to have recurrent or progressive neurologic symptoms. However, persistent facial nerve palsy caused dysfunctional and cosmetic problems in 11% of patients. Persistent nonspecific symptoms, such as headache and fatigue, were not more frequently reported in patients than in controls. Influence on daily life was reported to the same extent in patients and controls. Consequently, persistent headache and fatigue at follow-up should not be considered as attributable to NB. No prognostic factors could be identified.

CONCLUSIONS

Clinical recovery was satisfactory in children being evaluated for NB although persistent symptoms from facial nerve palsy occurred. Persistent nonspecific symptoms, such as headache and fatigue, were not more frequently reported in patients than in controls.

Authors+Show Affiliations

Pediatric Clinic at the University Hospital, Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. hedinskogman@ltdalarna.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19008771

Citation

Skogman, Barbro Hedin, et al. "Lyme Neuroborreliosis in Children: a Prospective Study of Clinical Features, Prognosis, and Outcome." The Pediatric Infectious Disease Journal, vol. 27, no. 12, 2008, pp. 1089-94.
Skogman BH, Croner S, Nordwall M, et al. Lyme neuroborreliosis in children: a prospective study of clinical features, prognosis, and outcome. Pediatr Infect Dis J. 2008;27(12):1089-94.
Skogman, B. H., Croner, S., Nordwall, M., Eknefelt, M., Ernerudh, J., & Forsberg, P. (2008). Lyme neuroborreliosis in children: a prospective study of clinical features, prognosis, and outcome. The Pediatric Infectious Disease Journal, 27(12), 1089-94. https://doi.org/10.1097/INF.0b013e31817fd423
Skogman BH, et al. Lyme Neuroborreliosis in Children: a Prospective Study of Clinical Features, Prognosis, and Outcome. Pediatr Infect Dis J. 2008;27(12):1089-94. PubMed PMID: 19008771.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lyme neuroborreliosis in children: a prospective study of clinical features, prognosis, and outcome. AU - Skogman,Barbro Hedin, AU - Croner,Stefan, AU - Nordwall,Maria, AU - Eknefelt,Mattias, AU - Ernerudh,Jan, AU - Forsberg,Pia, PY - 2008/11/15/pubmed PY - 2009/1/14/medline PY - 2008/11/15/entrez SP - 1089 EP - 94 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 27 IS - 12 N2 - BACKGROUND: Evaluation of children with clinically suspected neuroborreliosis (NB) is difficult. With a prospective study design we wanted to characterize children with signs and symptoms indicative for NB, investigate clinical outcome and, if possible, identify factors of importance for recovery. MATERIAL/METHODS: Children being evaluated for NB (n = 177) in southeast Sweden were categorized into 3 groups: "confirmed neuroborreliosis" (41%) with Borrelia antibodies in the cerebrospinal fluid, "possible neuroborreliosis" (26%) with pleocytosis but no Borrelia antibodies in the cerebrospinal fluid, and "not determined" (33%) with no pleocytosis and no Borrelia antibodies in the cerebrospinal fluid. Antibiotic treatment was given to 69% of children. Patients were followed during 6 months and compared with a matched control group (n = 174). RESULTS: Clinical recovery at the 6-month follow-up (n = 177) was generally good and no patient was found to have recurrent or progressive neurologic symptoms. However, persistent facial nerve palsy caused dysfunctional and cosmetic problems in 11% of patients. Persistent nonspecific symptoms, such as headache and fatigue, were not more frequently reported in patients than in controls. Influence on daily life was reported to the same extent in patients and controls. Consequently, persistent headache and fatigue at follow-up should not be considered as attributable to NB. No prognostic factors could be identified. CONCLUSIONS: Clinical recovery was satisfactory in children being evaluated for NB although persistent symptoms from facial nerve palsy occurred. Persistent nonspecific symptoms, such as headache and fatigue, were not more frequently reported in patients than in controls. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/19008771/Lyme_neuroborreliosis_in_children:_a_prospective_study_of_clinical_features_prognosis_and_outcome_ L2 - http://dx.doi.org/10.1097/INF.0b013e31817fd423 DB - PRIME DP - Unbound Medicine ER -