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Stütz, W.
Neuroborreliose im Kindesalter - Eine klinische und epidemiologische Charakteristik von Patienten der Universitätsklinik für Kinder- und Jugendheilkunde Graz von 2000 bis 2006 im Vergleich mit internationalen Daten
[ Diplomarbeit/Master Thesis ] Medizinische Universität Graz; 2009. pp.65. [OPEN ACCESS]
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Authors Med Uni Graz:
Advisor:: Zenz Werner; Zöhrer Bettina
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Abstract:: Introduction: We report a retrospective analysis of all inpatients treated for Lyme Neuroborreliosis (NB) at the University Clinic of Paediatrics and Adolescent Medicine Graz between January 2000 and December 2006. Methods: All medical records with an ICD-diagnosis related to NB at discharge were reviewed systematically concerning demographic data, clinical symptoms, serologic tests and cerebrospinal fluid (CSF) parameters. Results: Within seven years 81 patients (incidence 6,7 / 100,000 children) aged 23 months to 16.1 years (mean 8.2 years) were treated for NB. 59/81 (72.9%) patients were classified as having confirmed NB according to clinical picture, CSF pleocytosis and either intrathecal antibody synthesis (56/59; 94.9%) or positive CSF Borrelia culture (1/59; 1.7%) or both (1/59; 1.7%). One patient (1.7%) had a positive PCR result for Borrelia DNA from CSF. In 20/81 (24.7%) children clinical picture, serologic IgM or IgG antibodies and CSF pleocytosis were interpreted as most likely NB. 2/81 (2.4%) patients with clinical symptoms and positive IgM and/or IgG serum antibodies were classified as having possible NB. 60/81 (76.5%) children suffered from facial palsy, which corresponded to 43 (74.2%) confirmed, 16 (24.2%) most likely, one (1.6%) possible NB. 7/81 (8.6%) children with paralysis of other cranial nerves (III, IV, VI) had confirmed NB. In 13/81 (16%) patients recurrent headaches was the leading symptom of 8 (61.5%) confirmed, 4 (30.8%) most likely, one (7.7%) possible NB. Conclusion: In endemic regions Neuroborreliosis is a common disease in children. Facial palsy is the most frequent symptom of that disease in this age group, followed by recurrent headaches. In children with recurrent headaches and positive Borrelia serum antibodies further diagnostic methods should be considered.