Subscribe to RSS
DOI: 10.1055/s-0038-1627479
A Child with Unilateral Visual Impairment Caused by Neuroborreliosis
Publication History
20 November 2017
03 January 2018
Publication Date:
23 February 2018 (online)
Abstract
This case report describes a 7-year-old male patient with painless unilateral visual impairment due to optic neuropathy confirmed by visual evoked potentials (VEP), which was found to be attributed to neuroborreliosis. The diagnosis was confirmed by applying both European (European Federation of Neurological Societies [EFNS]) and American (Centers for Disease Control and Prevention [CDC]) criteria. Following intravenous treatment with broad-spectrum antibiotics, his vision gradually improved. This case report adds to the scarce evidence for an association between optic neuropathies and neuroborreliosis. It illustrates that, although uncommon, the clinician should be aware of the possibility of Lyme disease in patients with unilateral visual impairment due to optic neuropathy. Recognition is especially important because visual acuity can return to normal after adequate treatment. We reviewed the differences in criteria by the European EFNS guidelines and the American CDC criteria for making the diagnosis.
-
References
- 1 Steere AC. Lyme disease. N Engl J Med 2001; 345 (02) 115-125
- 2 Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwaldt E, Davis JP. Lyme disease-a tick-borne spirochetosis?. Science 1982; 216 (4552): 1317-1319
- 3 Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet 2012; 379 (9814): 461-473
- 4 Halperin JJ. Neurologic manifestations of lyme disease. Curr Infect Dis Rep 2011; 13 (04) 360-366
- 5 Halperin JJ. Nervous system lyme disease. Curr Infect Dis Rep 2015; 17 (01) 445
- 6 Rupprecht TA, Koedel U, Fingerle V, Pfister HW. The pathogenesis of lyme neuroborreliosis: from infection to inflammation. Mol Med 2008; 14 (3–4): 205-212
- 7 Pachner AR, Steere AC. The triad of neurologic manifestations of Lyme disease: meningitis, cranial neuritis, and radiculoneuritis. Neurology 1985; 35 (01) 47-53
- 8 Strle K, Drouin EE, Shen S. , et al. Borrelia burgdorferi stimulates macrophages to secrete higher levels of cytokines and chemokines than Borrelia afzelii or Borrelia garinii . J Infect Dis 2009; 200 (12) 1936-1943
- 9 Duray PH, Johnson RC. The histopathology of experimentally infected hamsters with the Lyme disease spirochete, Borrelia burgdorferi . Proc Soc Exp Biol Med 1986; 181 (02) 263-269
- 10 Johnson RC, Marek N, Kodner C. Infection of Syrian hamsters with Lyme disease spirochetes. J Clin Microbiol 1984; 20 (06) 1099-1101
- 11 Halperin JJ. Nervous system lyme disease: is there a controversy?. Semin Neurol 2011; 31 (03) 317-324
- 12 Träisk F, Lindquist L. Optic nerve involvement in Lyme disease. Curr Opin Ophthalmol 2012; 23 (06) 485-490
- 13 Träisk F, Andersson M, Svenungsson E. Three cases of neuroborreliosis misdiagnosed as giant cell arteritis. Scand J Rheumatol 2012; 41 (02) 158-160
- 14 Burkhard C, Gleichmann M, Wilhelm H. Optic nerve lesion following neuroborreliosis: a case report. Eur J Ophthalmol 2001; 11 (02) 203-206
- 15 Sibony P, Halperin J, Coyle PK, Patel K. Reactive Lyme serology in optic neuritis. J Neuroophthalmol 2005; 25 (02) 71-82
- 16 Mygland A, Ljøstad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I. ; European Federation of Neurological Societies. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol 2010; 17 (01) 8-16 , e1–e4
- 17 Centers for Disease Control and Prevention (CDC). Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. Morb Mortal Wkly Rep 1995; 44 (31) 590-591
- 18 Raucher HS, Kaufman DM, Goldfarb J, Jacobson RI, Roseman B, Wolff RR. Pseudotumor cerebri and Lyme disease: A new association. J Pediatr 1985; 107 (06) 931-933
- 19 Jacobson DM, Frens DB. Pseudotumor cerebri syndrome associated with lyme disease. Am J Ophthalmol 1989; 107 (01) 81-82
- 20 Rothermel H, Hedges III TR, Steere AC. Optic neuropathy in children with lyme disease. Pediatrics 2001; 108 (2 II): 477-481
- 21 Krim E, Guehl D, Burbaud P, Lagueny A. Retrobulbar optic neuritis: A complication of Lyme disease?. J Neurol Neurosurg Psychiatry 2007; 78 (12) 1409-1410
- 22 Blanc F, Ballonzoli L, Marcel C, De Martino S, Jaulhac B, de Seze J. Lyme optic neuritis. J Neurol Sci 2010; 295 (1-2): 117-119
- 23 Santino I, Comite P, Gandolfo GM. Borrelia burgdorferi, a great chameleon: Know it to recognize it!. Neurol Sci 2010; 31 (02) 193-196
- 24 Szanyi J, Kubová Z, Kremláček J. , et al. Pattern and motion-related visual-evoked potentials in neuroborreliosis: follow-up study. J Clin Neurophysiol 2012; 29 (02) 174-180