ro13-9904 and Pseudotumor-Cerebri

Pseudotumor cerebri is an unusual presentation of Lyme disease. The case of an 8-year-old girl with pseudotumor cerebri secondary to acute neuroborreliosis is reported. She presented with acute onset of headache, papilledema, sixth nerve palsy, increased intracranial pressure, and cerebrospinal fluid pleocytosis. Serum and cerebrospinal fluid Lyme antibodies were positive. Twelve reported cases that mostly presented with systemic findings and signs of Lyme disease before development of pseudotumor cerebri were reviewed. We conclude that acute neuroborreliosis can present with pseudotumor cerebri as an initial manifestation. It is important to include Lyme disease in the differential diagnosis of pseudotumor cerebri in an area endemic for Lyme disease.

Topics: Abducens Nerve; Acetazolamide; Borrelia burgdorferi Group; Carbonic Anhydrase Inhibitors; Ceftriaxone; Cephalosporins; Child; Cranial Nerve Diseases; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Lyme Disease; Meningoencephalitis; Pseudotumor Cerebri

Intracranial hypertension is a rare entity in prepubertal children, and its differential diagnosis includes a number of systemic diseases, drugs, vitamin deficiencies and excesses, and hereditary conditions. Infectious aetiology is rare. The case of a 9-year-old boy with intracranial hypertension secondary to acute neuroborreliosis is described. He presented with daily pulsatile frontotemporal headache, pallor, photophobia and phonophobia. His neurological examination revealed papilledema with no nuchal rigidity. The lumbar puncture showed increased pressure (50 cm H

Topics: Anti-Bacterial Agents; Blotting, Western; Borrelia burgdorferi; Ceftriaxone; Child; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; Humans; Lyme Neuroborreliosis; Male; Portugal; Pseudotumor Cerebri

Topics: Adult; Anti-Bacterial Agents; Antibodies; Borrelia; Ceftriaxone; Humans; Immunoglobulin M; Lyme Disease; Male; Pseudotumor Cerebri

Topics: Anti-Bacterial Agents; Ceftriaxone; Humans; Male; Middle Aged; Pseudotumor Cerebri

Neuroborreliosis is an infection of the nervous system caused by the spirochete Borrelia burgdorferi, from which patients most commonly develop lymphocytic meningitis, radiculoneuritis, or cranial neuropathy. In this report a 9-year-old male with an unusual neurological complication of neuroborreliosis--benign intracranial hypertension (BIH)--is described. Clinical symptoms of BIH, which consist of increased CSF pressure in the absence of an intracranial mass or obstruction to the circulation of CSF, resolved completely after antibiotic therapy with ceftriaxone.

Topics: Ceftriaxone; Cephalosporins; Cerebrospinal Fluid Pressure; Child; Humans; Lyme Neuroborreliosis; Male; Pseudotumor Cerebri; Treatment Outcome

Topics: Acetazolamide; Brain; Ceftriaxone; Child; Drug Therapy, Combination; Female; Heparin, Low-Molecular-Weight; Humans; Intracranial Pressure; Lyme Disease; Magnetic Resonance Imaging; Pseudotumor Cerebri; Sinus Thrombosis, Intracranial; Syndrome; Venous Thrombosis

Lyme borreliosis may cause a wide range of clinical symptoms. The two previously described paediatric cases of Lyme borreliosis with symptoms of pseudotumor cerebri were associated with characteristic cutaneous symptoms. A case of seven year-old girl with six weeks of headache, vomiting nausea and fatigue as the only symptoms was shown to suffer from pseudotumor cerebri with papilloedema and increased intracranial pressure caused Borrelia burgdorferi. Specific treatment with intravenous penicillin and later intravenous ceftriaxone (due to development of penicillin allergy) for a total of ten days caused the symptoms to gradually disappear over following three to four weeks. Hence, even if pseudotumor cerebri is the only symptom, it is recommended that testing for Lyme borreliosis should be carried out.

Topics: Ceftriaxone; Child; Diagnosis, Differential; Female; Humans; Injections, Intravenous; Lyme Disease; Penicillins; Pseudotumor Cerebri