莱姆病合并视乳头水肿：一项临床特征和结局的回顾性研究。
Lyme Disease and Papilledema: A Retrospective Study on Clinical Characteristics and Outcomes.
机构信息
Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Child Neurol. 2024 Aug;39(9-10):334-342. doi: 10.1177/08830738241273376. Epub 2024 Sep 2.
OBJECTIVE
Describe the clinical characteristics, treatment strategies, and outcome data of children with papilledema associated with Lyme disease at a large tertiary care pediatric hospital.
METHODS
Retrospective cohort study of children 1-18 years old who received care at our institution between 1995 and 2019 with concurrent diagnoses of papilledema and Lyme disease. Data were abstracted from records and prospective family surveys.
RESULTS
Among 44 children included (median age 9.7 years), 66% (29/44) had additional cranial neuropathies, and 78% (32/41) had cerebrospinal fluid pleocytosis. All children were treated with antibiotics (39% oral, 55% intravenous, 7% both); 61% (27/44) were also treated with oral acetazolamide. Symptoms fully resolved in 86% (30/35) of children with follow-up data. Proportion recovered did not significantly differ by antibiotic administration route or presence/absence of cerebrospinal fluid pleocytosis.
CONCLUSIONS
Papilledema in Lyme disease may occur with or without cerebrospinal fluid pleocytosis. Most children recover without residual deficits following treatment, although exceptions exist.
目的
描述大型三级儿科医院中与莱姆病相关的脑压增高症患儿的临床特征、治疗策略和结果数据。
方法
对 1995 年至 2019 年期间在我院就诊且同时诊断为脑压增高症和莱姆病的 1-18 岁儿童进行回顾性队列研究。从病历和前瞻性家庭调查中提取数据。
结果
在纳入的 44 名儿童中（中位年龄 9.7 岁），66%（29/44）存在其他颅神经病变，78%（32/41）存在脑脊液白细胞增多。所有儿童均接受抗生素治疗（39%口服，55%静脉注射，7%两者兼用）；61%（27/44）还接受了口服乙酰唑胺治疗。有随访数据的 35 名儿童中，86%（30/35）的症状完全缓解。抗生素给药途径或脑脊液白细胞增多的存在与否对恢复比例没有显著影响。
结论
莱姆病可伴有或不伴有脑脊液白细胞增多症出现脑压增高症。大多数儿童在接受治疗后无残留缺陷恢复，但也存在例外情况。
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