Kurian Mary, Pereira Vitor Mendes, Vargas Maria Isabel, Fluss Joel
Pediatric Neurology, Pediatric Subspecialties Service, Children's Hospital, Geneva, Switzerland
Neuroradiology Unit, University Hospitals, Geneva, Switzerland.
J Child Neurol. 2015 Aug;30(9):1226-9. doi: 10.1177/0883073814552104. Epub 2014 Oct 14.
Stroke-like presentation in Lyme neuroborreliosis is rare in the pediatric age group. We report a previously healthy 12-year-old boy who presented with acute left hemiparesis and meningeal signs. Neuroimaging failed to reveal any cerebral infarction but demonstrated a multifocal cerebral vasculitis involving small, medium and large-sized vessels affecting both the anterior and posterior circulation. Concentric contrast enhancement of the basilar artery was also observed. Further investigations and laboratory findings were consistent with Lyme neuroborreliosis. A rapidly favorable clinical outcome was obtained with appropriate antibiotic treatment along with antiaggregants and steroids. Lyme neuroborreliosis should be considered in the diagnostic differential, not only in adults but also among children, especially in the context of an unexplained cerebral vasculitis.
莱姆病性神经伯氏疏螺旋体病（Lyme neuroborreliosis）在儿童年龄组中出现类似中风的表现较为罕见。我们报告了一名此前健康的12岁男孩，他出现急性左半身轻瘫和脑膜刺激征。神经影像学检查未发现任何脑梗死，但显示出一种多灶性脑血管炎，累及小、中、大型血管，影响前循环和后循环。还观察到基底动脉的同心性对比增强。进一步的检查和实验室检查结果与莱姆病性神经伯氏疏螺旋体病一致。通过适当的抗生素治疗以及抗血小板药物和类固醇药物，获得了迅速良好的临床结果。在鉴别诊断中应考虑莱姆病性神经伯氏疏螺旋体病，不仅在成人中，在儿童中也应考虑，尤其是在不明原因的脑血管炎的情况下。
