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J Child Neurol. 2015 Aug;30(9):1226-9. doi: 10.1177/0883073814552104. Epub 2014 Oct 14.

Stroke-like Phenomena Revealing Multifocal Cerebral Vasculitis in Pediatric Lyme Neuroborreliosis.

Author information

1
Pediatric Neurology, Pediatric Subspecialties Service, Children's Hospital, Geneva, Switzerland mary.kurian@hcuge.ch.
2
Neuroradiology Unit, University Hospitals, Geneva, Switzerland.
3
Pediatric Neurology, Pediatric Subspecialties Service, Children's Hospital, Geneva, Switzerland.

Abstract

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.

KEYWORDS:

lyme; neuroborreliosis; pediatric; stroke; stroke-like; vasculitis

PMID:
25316727
DOI:
10.1177/0883073814552104
[Indexed for MEDLINE]

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