Bacterial meningitis and Lyme neuroborreliosis in childhood.

Neurologic infections represent a major problem in child neurology. Recent research on this issue has had important implications for diagnosis and pathophysiology of infectious diseases of the child's brain, resulting in new therapeutic approaches. A better understanding of the molecular pathophysiology of bacterial meningitis has developed, and therapeutic interventions focus on the host's inflammatory response. Therapeutic trials with dexamethasone in addition to antibiotic treatment have yielded promising results in reducing morbidity and long-term neurologic sequelae in bacterial meningitis. The detection of Lyme borreliosis in 1977 substantially influenced the differential diagnosis of inflammatory central nervous system diseases. Lyme neuroborreliosis proved a main cause of acute peripheral facial palsy and aseptic meningitis in children. An effective antibiotic treatment has become available for a large number of patients with these illnesses.