Pediatric stroke related to Lyme neuroborreliosis: Data from the Swiss NeuroPaediatric Stroke Registry and literature review

Monteventi, Olivia; Steinlin, Maja; Regényi, Mária; Roulet-Perez, Eliane; Weber, Peter; Fluss, Joël Victor

doi:10.1016/j.ejpn.2017.10.010

Cited by 18 publications

(15 citation statements)

References 35 publications

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“…In addition to inflammation of the vessel wall, thrombosis of the affected vessels has been discussed in LNB. 2 This was observed in patient 2, as thrombotic BA occlusion led to a hyperdense BA sign in CCT and to a blooming artifact (susceptibility vessel sign) 29 on SWI images. The rapid clinical improvement after successful EVT with TICI 3 recanalization and reappearance of pontine branches would not have been observed had vessel inflammation been the only cause of BA occlusion.…”

Section: Discussionmentioning

confidence: 80%

“…Although a rare event, cerebrovascular manifestations of LNB have been reported as potential cause of childhood AIS, especially in European regions with high prevalence of Borrelia garinii . 2 Management of childhood AIS due to LNB consists of early antibiotic treatment, usually a third-generation cephalosporine. 3,4 Platelet inhibition with acetyl-salicylic acid (ASA) as secondary prevention and steroids as treatment of inflammatory arteriopathy have been discussed in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Hyperacute treatment of childhood stroke in Lyme neuroborreliosis: report of two cases and systematic review of the literature

Philipps

Erdlenbruch

Kuschnerow

et al. 2022

Ther Adv Neurol Disord

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The safety and efficacy of hyperacute reperfusion therapies in childhood stroke due to focal cerebral arteriopathy (FCA) with an infectious and inflammatory component is unknown. Lyme neuroborreliosis (LNB) is reported as a rare cause of childhood stroke. Intravenous thrombolysis (IVT) and endovascular therapy (EVT) have not been reported in LNB-associated stroke in children. We report two children with acute stroke associated with LNB who underwent hyperacute stroke treatment. A systematic review of the literature was performed to identify case reports of LNB-associated childhood stroke over the last 20 years. Patient 1 received IVT within 73 min after onset of acute hemiparesis and dysarthria; medulla oblongata infarctions were diagnosed on magnetic resonance imaging (MRI). Patient 2 received successful EVT 6.5 hr after onset of progressive tetraparesis, coma, and decerebrate posturing caused by basilar artery occlusion with bilateral pontomesencephalic infarctions. Both patients exhibited a lymphocytic cerebrospinal fluid (CSF) pleocytosis and elevated antibody index (AI) to Borrelia burgdorferi. Antibiotic treatment, steroids, and platelet inhibitors including tirofiban infusion in patient 2 were administered. No side effects were observed. On follow-up, patient 1 showed good recovery and patient 2 was asymptomatic. In the literature, 12 cases of LNB-associated childhood stroke were reported. LNB-associated infectious and inflammatory FCA is not a medical contraindication for reperfusion therapies in acute childhood stroke. Steroids are discussed controversially in inflammatory FCA due to LNB. Intensified antiplatelet regimes may be considered; secondary prophylaxis with acetyl-salicylic acid (ASA) is recommended because of a high risk of early stroke recurrence.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Hyperacute treatment of childhood stroke in Lyme neuroborreliosis: report of two cases and systematic review of the literature

Philipps

Erdlenbruch

Kuschnerow

et al. 2022

Ther Adv Neurol Disord

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“…Acute disseminated encephalomyelitis or rare vascular complications such as stroke in children have also been reported in the literature. Particularly in endemic areas, early and late NB should be considered as a potential cause of stroke in children and young adults (16).…”

Section: Patogenezamentioning

confidence: 99%

“…Due to the clinical and biological similarity of NB to lymphocytic meningitis, especially those caused by udaru u dzieci i młodych dorosłych należy brać pod uwagę wczesną i późną NB (16).…”

Section: Obraz Kliniczyunclassified

Neuroborreliosis – clinical presentation – Current state of knowledge

Krawczuk¹,

Czupryna

Pancewicz

et al. 2019

Przegl Epidemiol

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Neuroborreliosis is one of the manifestations of Lyme disease involving central and peripheral nervous system. It is caused by infection with Borrelia burgdorferi spirochete which is transmitted by tick bites. Neuroborreliosis can affect both adults and children. The clinical course in children is often different than in adults. The article discusses the most common clinical symptoms, complications, diagnostics and treatment of neuroborreliosis in children.

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“…Furthermore, a latent neuroborreliosis can exist for quite some time without significant symptoms, then present with late CNS involvement many months to years after initial infection and less characteristic symptoms (11). Symptoms may include facial paralysis and other cranial neuropathies, headache, neck stiffness, fatigue, paresthesias, meningeal signs, depression, anxiety disorders, peripheral nervous system problems, encephalitis or encephalomyelitis, chronic meningitis, and stroke secondary to cerebral vasculitis (11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Symptom Clusters and Functional Impairment in Individuals Treated for Lyme Borreliosis

et al. 2020

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Context: Persistent fatigue, pain, and neurocognitive impairment are common in individuals following treatment for Lyme borreliosis (LB). Poor sleep, depression, visual disturbance, and sensory neuropathies have also been reported. The cause of these symptoms is unclear, and widely accepted effective treatment strategies are lacking. Objectives: To identify symptom clusters in people with persistent symptoms previously treated for LB and to examine the relationship between symptom severity and perceived disability. Methods: This was a retrospective chart review of individuals with a history of treatment of LB referred to The Dean Center for Tick-Borne Illness at Spaulding Rehabilitation Hospital between 2015 and 2018 (n = 270) because of persistent symptoms. Symptoms and functional impairment were collected using the General Symptom Questionnaire-30 (GSQ-30), and the Sheehan Disability Scale. Clinical tests were conducted to evaluate for tick-borne co-infections and to rule out medical disorders that could mimic LB symptomatology. Exploratory factor analysis was performed to identify symptom clusters. Results: Five symptom clusters were identified. Each cluster was assigned a name to reflect the possible underlying etiology and was based on the majority of the symptoms in the cluster: the neuropathy symptom cluster, sleep-fatigue symptom cluster, migraine symptom cluster, cognitive symptom cluster, and mood symptom cluster. Symptom severity for each symptom cluster was positively associated with global functional impairment (p < 0.001). Conclusion: Identifying the interrelationship between symptoms in post-treatment LB in a cluster can aid in the identification of the etiological basis of these symptoms and could lead to more effective symptom management strategies. Zubcevik et al. Symptom Clusters in Lyme Borreliosis Key Message: This article describes symptom clusters in individuals with a history of Lyme borreliosis. Five clusters were identified: sleep-fatigue, neuropathy, migrainelike, cognition, and mood clusters. Identifying the interrelationship between symptoms in each of the identified clusters could aid in more effective symptom management through identifying triggering symptoms or an underlying etiology.

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Pediatric stroke related to Lyme neuroborreliosis: Data from the Swiss NeuroPaediatric Stroke Registry and literature review

Cited by 18 publications

References 35 publications

Hyperacute treatment of childhood stroke in Lyme neuroborreliosis: report of two cases and systematic review of the literature

Hyperacute treatment of childhood stroke in Lyme neuroborreliosis: report of two cases and systematic review of the literature

Neuroborreliosis – clinical presentation – Current state of knowledge

Symptom Clusters and Functional Impairment in Individuals Treated for Lyme Borreliosis

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