Cerebellar ataxia as the presenting manifestation of lyme disease

• Published in: The Pediatric infectious disease journal Vol. 21; no. 4; pp. 353 - 356
• Main Authors: Arav-Boger, Ravit, Crawford, Thomas, Steere, Allen C, Halsey, Neal A
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Lippincott Williams & Wilkins, Inc 01-04-2002; Philadelphia, PA Lippincott; Hagerstown, MD
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bartonellosis; Biological and medical sciences; Borrelia burgdorferi - isolation & purification; Borrelia burgdorferi - pathogenicity; Borrelia infections; Cerebellar Ataxia - etiology; Cerebrospinal Fluid - microbiology; Child; Diagnosis, Differential; Headache - etiology; Human bacterial diseases; Humans; Infectious diseases; Lyme Disease - complications; Lyme Disease - diagnosis; Lyme Disease - drug therapy; Male; Medical sciences; Tropical bacterial diseases; Human; Lyme disease; Nervous system diseases; Cerebellar ataxia; Borrelia infection; Infection; Case study; Symptomatology; Spirochaetosis; Central nervous system disease; Bacteriosis; Child; Inaugural sign
• DOI: 10.1097/00006454-200204000-00021
• EISSN: 1532-0987
• ISSN: 0891-3668

A 7-year-old boy from suburban Baltimore who presented with cerebellar ataxia and headaches was found by magnetic resonance imaging to have multiple cerebellar enhancing lesions. He had no history of tick exposure. He was initially treated with steroids for presumptive postinfectious encephalitis. Lyme disease was diagnosed 10 weeks later after arthritis developed. Testing of the cerebrospinal fluid obtained at the time cerebellar ataxia was diagnosed revealed intrathecal antibody production to Borrelia burgdorferi. Treatment with intravenous antibiotics led to rapid resolution of persistent cerebellar findings.