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Clinical presentation of childhood neuroborreliosis; neurological examination may be normal.
Arch Dis Child. 2010 Nov; 95(11):910-4.AD

Abstract

OBJECTIVE

Neuroborreliosis has its highest incidence in children and the older people. Signs and symptoms are different between the different age groups. The aim of this study was to describe the clinical spectrum of neuroborreliosis in children.

DESIGN

The Dutch Paediatric Surveillance system registered cases of childhood neuroborreliosis during 2 years. All Dutch paediatric hospitals took part in this surveillance. Criteria for reporting cases were strictly defined.

RESULTS

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.

Authors+Show Affiliations

Department of Paediatrics, Isala Clinics, Zwolle, The Netherlands. d.m.broekhuijsen@isala.nlNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20584849

Citation

Broekhuijsen-van Henten, Dorien M., et al. "Clinical Presentation of Childhood Neuroborreliosis; Neurological Examination May Be Normal." Archives of Disease in Childhood, vol. 95, no. 11, 2010, pp. 910-4.
Broekhuijsen-van Henten DM, Braun KP, Wolfs TF. Clinical presentation of childhood neuroborreliosis; neurological examination may be normal. Arch Dis Child. 2010;95(11):910-4.
Broekhuijsen-van Henten, D. M., Braun, K. P., & Wolfs, T. F. (2010). Clinical presentation of childhood neuroborreliosis; neurological examination may be normal. Archives of Disease in Childhood, 95(11), 910-4. https://doi.org/10.1136/adc.2009.176529
Broekhuijsen-van Henten DM, Braun KP, Wolfs TF. Clinical Presentation of Childhood Neuroborreliosis; Neurological Examination May Be Normal. Arch Dis Child. 2010;95(11):910-4. PubMed PMID: 20584849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical presentation of childhood neuroborreliosis; neurological examination may be normal. AU - Broekhuijsen-van Henten,Dorien M, AU - Braun,Kees P J, AU - Wolfs,Tom F W, Y1 - 2010/06/28/ PY - 2010/6/30/entrez PY - 2010/6/30/pubmed PY - 2010/12/14/medline SP - 910 EP - 4 JF - Archives of disease in childhood JO - Arch Dis Child VL - 95 IS - 11 N2 - OBJECTIVE: Neuroborreliosis has its highest incidence in children and the older people. Signs and symptoms are different between the different age groups. The aim of this study was to describe the clinical spectrum of neuroborreliosis in children. DESIGN: The Dutch Paediatric Surveillance system registered cases of childhood neuroborreliosis during 2 years. All Dutch paediatric hospitals took part in this surveillance. Criteria for reporting cases were strictly defined. RESULTS: 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. SN - 1468-2044 UR - https://www.unboundmedicine.com/medline/citation/20584849/Clinical_presentation_of_childhood_neuroborreliosis L2 - https://adc.bmj.com/lookup/pmidlookup?view=long&pmid=20584849 DB - PRIME DP - Unbound Medicine ER -