Cerebral vasculitis and intracranial multiple aneurysms in a child with Lyme neuroborreliosis.

JMM case reports Pub Date : 2017-04-21 eCollection Date: 2017-04-01 DOI:10.1099/jmmcr.0.005090
Elisa Kortela, Jukka Hytönen, Jussi Numminen, Margit Overmyer, Harri Saxen, Jarmo Oksi
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引用次数: 2

Abstract

Introduction. Lyme borreliosis is a multisystem tick-borne disease caused by Borrelia burgdorferi. Neurological manifestations are reported in up to 15 % of adult patients with Lyme disease, while the frequency among children is higher. The most common manifestations are painful radiculopathy, facial nerve paresis and lymphocytic meningitis. Epileptic seizures and cerebral vasculitis with stroke or aneurysms are very rare complications. Case presentation. We describe a paediatric patient with sensorineural auditory dysfunction, headache, fatigue and epileptic seizures as sequelae of meningoencephalitis/Lyme neuroborreliosis (LNB) caused by B. burgdorferi. Brain magnetic resonance imaging revealed widespread enhancement of the leptomeninges, cranial nerves and artery walls compatible with vasculitis and disturbances in cerebrospinal fluid (CSF) circulation. The patient was treated with ceftriaxone for 2 weeks. Two years later, the patient had an ischemic stroke. Brain magnetic resonance angiography revealed multiple aneurysms, which were not present previously. The largest aneurysm was operated rapidly. The patient was treated with another course of intravenous ceftriaxone for 4 weeks and pulse therapy with corticosteroids. He recovered well.

Conclusion: . This unique case demonstrates complications of LNB that can result in serious morbidity or even mortality. Lumbar puncture and analysis should be considered for paediatric patients with epileptic seizures or cerebrovascular events living in a Lyme borreliosis endemic area.

Abstract Image

Abstract Image

莱姆病儿童的脑血管炎和颅内多发动脉瘤。
介绍。莱姆病是一种由伯氏疏螺旋体引起的多系统蜱传疾病。据报道,高达15%的成年莱姆病患者有神经系统症状,而儿童的发病率更高。最常见的表现是疼痛性神经根病、面神经麻痹和淋巴细胞性脑膜炎。癫痫发作和脑血管炎合并中风或动脉瘤是非常罕见的并发症。案例演示。我们描述了一位由伯氏疏螺旋体引起的脑膜脑炎/莱姆性神经疏螺旋体病(LNB)的后遗症引起的感觉神经性听觉功能障碍,头痛,疲劳和癫痫发作的儿科患者。脑磁共振成像显示轻脑膜、脑神经和动脉壁广泛增强,与血管炎和脑脊液循环紊乱相一致。患者给予头孢曲松治疗2周。两年后,病人患上了缺血性中风。脑磁共振血管造影显示多个动脉瘤,这是以前没有出现。最大的动脉瘤迅速手术。患者给予另一个疗程的头孢曲松静脉注射4周和皮质类固醇脉冲治疗。他恢复得很好。结论:。这个独特的病例表明LNB的并发症可导致严重的发病率甚至死亡。生活在莱姆病疫区的儿童癫痫发作或脑血管事件患者应考虑腰椎穿刺和分析。
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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