Lyme Disease and Papilledema: A Retrospective Study on Clinical Characteristics and Outcomes.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Child Neurology Pub Date : 2024-08-01 Epub Date: 2024-09-02 DOI:10.1177/08830738241273376

Joseph Vithayathil, Akash Virupakshaiah, Geraldine Liu, Sanjeev K Swami, Robert A Avery, Grant T Liu, Jennifer L McGuire

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引用次数: 0

Abstract

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.

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莱姆病与乳头水肿：临床特征与疗效回顾性研究

摘要描述一家大型三级儿科医院中乳头水肿合并莱姆病患儿的临床特征、治疗策略和结果数据：回顾性队列研究：1995 年至 2019 年期间在本院接受治疗的 1-18 岁同时诊断为乳头水肿和莱姆病的儿童。数据摘自病历和前瞻性家庭调查：在纳入的44名儿童（中位年龄为9.7岁）中，66%（29/44）患有其他颅神经病变，78%（32/41）患有脑脊液多细胞症。所有患儿均接受了抗生素治疗（39%口服，55%静脉注射，7%两者兼用）；61%（27/44）的患儿还接受了口服乙酰唑胺治疗。在有随访数据的患儿中，86%（30/35）的患儿症状完全缓解。痊愈的比例在抗生素给药途径或是否出现脑脊液多细胞现象方面没有明显差异：结论：莱姆病的脑膜水肿可伴有或不伴有脑脊液多核细胞增多。结论：莱姆病患者出现乳头水肿时可能伴有或不伴有脑脊液多形性红细胞增多，大多数患儿在治疗后可痊愈，不会遗留后遗症，但也有例外。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Child Neurology 医学-临床神经学

CiteScore

4.20

自引率

5.30%

发文量

111

审稿时长

3-6 weeks

期刊介绍： The Journal of Child Neurology (JCN) embraces peer-reviewed clinical and investigative studies from a wide-variety of neuroscience disciplines. Focusing on the needs of neurologic patients from birth to age 18 years, JCN covers topics ranging from assessment of new and changing therapies and procedures; diagnosis, evaluation, and management of neurologic, neuropsychiatric, and neurodevelopmental disorders; and pathophysiology of central nervous system diseases.