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Clinical characteristics of Lyme neuroborreliosis in Dutch children and adults

European Journal of Pediatrics volume 182, pages 1183–1189 (2023)Cite this article

Abstract

Lyme neuroborreliosis (LNB) is a tick-borne infection caused by Borrelia burgdorferi which can affect the nervous system in adults and children. The clinical course of LNB in adults is often different than in children. Studies comparing these differences are scarce. The aim of this study was to compare the clinical characteristics and outcome of LNB between children and adults. We performed an observational retrospective study among patients with LNB who presented at Gelre Hospital from 2007 to 2020 and had cerebrospinal fluid pleocytosis. Data were collected from electronic medical records. A total of 127 patients with LNB were identified. Included were 58 children (median age 8 years) and 69 adults (median age 56 years). The incidence of LNB was 3.2 per 100,000 inhabitants per year. The most common neurological manifestation in adults and in children was facial nerve palsy (67%). Unilateral facial nerve palsy was more prevalent in children (85%) than in adults (42%) (P < 0.001). Headache was also more prevalent in children (59%) than in adults (32%) (P = 0.003). (Poly)radiculitis was more prevalent in adults (51%) than in children (3%) (P < 0.001), encephalitis was not reported in children. In children, the time between symptom onset and diagnosis was 10 days versus 28 days in adults (P < 0.001). Complete recovery was reported significantly more often in children (83%) compared to adults (40%) (P < 0.001).

   Conclusion: In a Lyme-endemic area in the Netherlands, LNB commonly presents with facial nerve palsy. Facial nerve palsy and headache are more prevalent in children, while radiculitis and encephalitis are mostly reported in adults.

What is Known:

• The clinical course of Lyme neuroborreliosis in adults is often different from children.

.

• The aim of this study was to compare the clinical characteristics and outcome of LNB between children and adults.

What is New:

• Lyme neuroborreliosis in the Netherlands commonly presents with facial nerve palsy.

• Facial nerve palsy and headache are more prevalent in children than in adults. Radiculitis and encephalitis are mostly reported in adults.

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Fig. 1

Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Author notes

  1. A. van Samkar and R. A. Bruinsma contributed equally to this work.

Authors and Affiliations

  1. Lyme Centre Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands

    A. van Samkar, R. A. Bruinsma, Y. M. Vermeeren, R. G. Wieberdink, T. van Bemmel, B. van Kooten & T. P. Zomer

  2. Department of Pediatrics, Gelre Hospital, Apeldoorn, the Netherlands

    R. A. Bruinsma

  3. Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands

    Y. M. Vermeeren & T. van Bemmel

  4. Department of Neurology, Gelre Hospital, Apeldoorn, the Netherlands

    R. G. Wieberdink

  5. Department of Medical Microbiology and Infection Prevention, Gelre Hospital, Apeldoorn, the Netherlands

    P. M. den Reijer

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  1. A. van Samkar
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Contributions

RB, YV, RW, TB, BK, and TZ contributed to the conception and design of the study. AS, RB, YV, RW, TB, BK, PR, and TZ contributed to acquisition and analysis of data. AS, RB, and TZ contributed to drafting the text or preparing the figures. All authors reviewed the manuscript.

Corresponding author

Correspondence to T. P. Zomer.

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The authors declare no competing interests.

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Communicated by Peter de Winter

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van Samkar, A., Bruinsma, R.A., Vermeeren, Y.M. et al. Clinical characteristics of Lyme neuroborreliosis in Dutch children and adults. Eur J Pediatr 182, 1183–1189 (2023). https://doi.org/10.1007/s00431-022-04749-5

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Keywords

  • Lyme neuroborreliosis
  • Lyme disease
  • Borrelia
  • Facial palsy
  • Children