The Lyme Disease Network
Medical / Scientific Abstract


Title:Cerebrospinal fluid findings in children with Lyme disease-associated facial nerve palsy.
Authors:Belman AL, Reynolds L, Preston T, Postels D, Grimson R, Coyle PK
Source:Arch Pediatr Adolesc Med 1997 Dec;151(12):1224-8
Organization:Department of Neurology, School of Medicine, State University of New York at Stony Brook, USA. abelman@neuro.som.sunysb.edu

Abstract:
OBJECTIVE: To determine the relative frequency of abnormal cerebrospinal fluid (CSF) findings in children with Lyme disease-associated facial nerve palsy. DESIGN: A clinical series. A prospective evaluation was undertaken of the condition of children seen between 1988 and 1996 at a single medical center in a Lyme disease endemic area. PATIENTS: Forty children (24 boys and 16 girls, aged 3-19 years) with new onset facial nerve palsy who met the Centers for Disease Control and Prevention case definition of Lyme disease. INTERVENTIONS: Neurologic examinations. Cerebrospinal fluid analysis. MAIN OUTCOME MEASURES: Rates of abnormal CSF findings: white blood cell count, protein level, and Borrelia burgdorferi-specific CSF assays. RESULTS: Cerebrospinal fluid white blood cell count, protein level, or both were abnormal in 27 (68%) of the children. Thirty-six (90%) of the 40 children had a CSF abnormality consistent with central nervous system infection or immune involvement by B burgdorferi. Of the 22 children with CSF pleocytosis, only 7 (32%) had headache and none had meningeal signs. CONCLUSIONS: Most children with Lyme disease-associated facial nerve palsy have CSF abnormalities. Our studies indicate that, in endemic areas, facial nerve palsy in children may be a marker of Lyme disease and occult meningitis. When Lyme disease is suspected, CSF should be examined; in some cases, it may be helpful to expand beyond routine CSF studies to look at a battery of B burgdorferi-specific assays.

Keywords:
Adolescence, Adult, Antigens, Bacterial, IMMUNOLOGY, Borrelia burgdorferi, IMMUNOLOGY, Child, Child, Preschool, Diagnosis, Differential, Facial Paralysis, MICROBIOLOGY, Female, Human, Immunoglobulins, BLOOD, IMMUNOLOGY, Lyme Disease, CEREBROSPINAL FLUID, COMPLICATIONS, IMMUNOLOGY, MICROBIOLOGY, Male, Prospective Studies, Spinal Puncture, Support, Non-U.S. Gov't, Support, U.S. Gov't, P.H.S.

Language: Eng

Unique ID: 98074074


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