Mumps meningoencephalitis. Prolonged abnormality of cerebrospinal fluid

Azimi, Parvin H.

doi:10.1001/jama.234.11.1161

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…Threequarters of the children showed complete motor loss of the facial nerve on admission, both for children with and without Lyme borreliosis (for case descriptions see Figs. [18][19][20][21]. There appeared to be no preferred side of the face to be affected by facial palsy.…”

Section: Lyme Borreliosis In Children: Retrospective Clinical and Lmentioning

confidence: 99%

Epidemiology and Clinical Manifestations of Lyme Borreliosis in Childhood

Christen¹,

Hanefeld²,

Eiffert³

et al. 1993

Acta Paediatrica

183

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. Lyme borreliosis is a tick‐borne infection caused by the spirochete Borrelia burgdorferi, whose discovery in 1982 solved an aetiological mystery involving a variety of dcrmatological and neurological disorders and explained their association with Lyme disease. Lyme borreliosis occurs frequently and is readily treatable with antibiotics. Along with its discovery, however, came the realization that it is difficult to diagnose accurately, especially antibody diagnosis. False‐positive antibody results in particular led to gradual widening of the clinical spectrum, and differential diagnosis became increasingly difficult. This prospective, multicentre study presents a systematic description of Lyme borreliosis in childhood, emphasizing epidemiological and clinical issues. Because, predominantly, inpatients were examined, Lyme neuroborreliosis was the focus of the study, with the chief concern being to minimize false‐positive results. To this end, we chose to narrow the diagnostic criteria, using the presence of specific antibodies in the cerebrospinal fluid as the determining factor. The epidemiological investigation was focused on the incidence of Lyme neuroborreliosis in childhood in southern Lower Saxony as well as on the prevalence of Lyme neuroborreliosis among acute‐inflammatory neurological illnesses in children. The clinical part of the study aimed at establishing criteria for differential diagnosis in addition to the detection of specific antibodies. The detection of specific IgM antibodies using an IgM capture ELISA confirmed the presence of acute Lyme borreliosis. The study examined 208 children with Lyme borreliosis, of whom 169 had Lyme neuroborreliosis, from mid‐1986 until the end of 1989. The yearly incidence of Lyme neuroborreliosis in Lower Saxony was 5.8 cases/100,000 children aged 1 to 13. The manifestation index was 0.16, or one case of Lyme neuroborreliosis per 620 infected children, compared with the presence of specific antibodies against B. burgdorferi for children in the same age group and region. Both the seasonal distribution of Lyme borreliosis, which peaked in summer and autumn, as well as the information about when the tick bites took place point to an incubation period of a few weeks. The most frequent manifestation of Lyme neuroborreliosis in childhood was acute peripheral facial palsy, found in 55% of all cases (n = 93). Lyme borreliosis proved to be the most frequently verifiable cause of acute peripheral facial palsy in children, causing every second case of this disorder in summer and autumn. Bilateral facial palsy was, without exception, found to be caused by Lyme borreliosis; thus it can be considered a specific neurological sign of this infection. The second most common manifestation of Lyme neuroborreliosis in childhood was aseptic meningitis (27.2%, n = 46). Lyme borreliosis was the third most common cause of aseptic meningitis in childhood (11.8%). Meningoradiculoneuritis with peripheral nerve involvement (Bannwarth syndrome) was diagnosed in only 3.6% of the childr...

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Section: Lyme Borreliosis In Children: Retrospective Clinical and Lmentioning

confidence: 99%

Epidemiology and Clinical Manifestations of Lyme Borreliosis in Childhood

Christen¹,

Hanefeld²,

Eiffert³

et al. 1993

Acta Paediatrica

183

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“…But this type of aseptic meningitis must be differentiated from chronic aseptic meningitis, which has a heterogeneous spectrum of causes. The protracted course of aseptic meningitis is most often seen in connection with mumps viral infections (18,258,268,283,323,343). Prolonged courses of 1 5…”

Section: Authormentioning

confidence: 99%

Section: 6mentioning

confidence: 99%

Abstract

1993

Acta Paediatrica

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“…Die Symptome der abakteriellen Meningitis dauern gewöhnlich wenige Tage bis zu zwei Wochen an, die erhöhte Zellzahl und die erhöhten Gesamteiweißwerte sinken rasch ab (Bell and McCormick 1981). Eine verlängerte entzündliche Reaktion der Meningen, die zu einem Persistieren oder sogar zu einem weiteren Anstieg von Zellzahl und Gesamteiweißkonzentration führt, scheint jedoch ein nicht ganz seltener Befund zu sein, insbesondere bei der Mumpsmeningitis (Russei and Donald 1958, Scheid 1961, Wilfert 1969, Asimi et al 1975. Die meisten der Patienten mit diesem Liquorbefund zeigten klinisch keine Hinweise auf diese Komplikation, einige aber klagten über subjektive Beschwerden, wie Krankheitsgeflihl, leichte Erschöpfbarkeit, Schwindel oder intermittierende Kopfschmerzen (Lepow 1962, Bell andMcCormick 1981 Kontrollen 132 1 21,1 6,3 1,4 58,7 3,5 0,9 -3,6 -3,9 1,4 7,7 1,7 4,5 1,5 1,4 2,7 0,8 bzw.…”

Section: Introductionunclassified

Die prolongierte abakterielle Meningitis: Klinische Aspekte und Liquorbefunde

Siemes¹,

Siegert²

1984

Klin Padiatr

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Ten to 28 days after hospital admission cell count and/or total protein concentration showed no decrease or further increase in 33 children (25 boys, 8 girls) between 2 to 15-years of age who suffered from acute aseptic meningitis (causative agents: mumps virus in 9 children, enterovirus in 5 children). Three of these children had cerebral palsy as a possible predisposing factor. The onset of prolonged aseptic meningitis was protracted in some children. At hospital admission the clinical features of this disorder differed not from those in uncomplicated acute aseptic meningitis. In 4 children a one-sided and in 4 patients a doublesided peripheral facial paralysis occurred as a transitory complication. One child showed transient arterial hypertension. EEG was normal in most of the children or revealed a slight general slowing only. Apart from a slight enlargement of the ventricles in 3 children cerebral CT showed no abnormality. Complaints like vertigo, headache, and vomiting persisted for weeks or months in part of the children. During the course of the disease CSF reflected two different reactions: 1. further increase of total protein in combination with a minimal cellular response, affecting 2-10 years old boys and girls equally; protein electrophoresis revealing the pattern of severe blood-CSF barrier disturbance, 2. persistant elevation or further increase of both cell count and total protein occurring nearly exclusively in 6-15 years old boys, associated with the CSF-protein pattern of severe blood-CSF barrier disturbance and of oligoclonal gamma-fractions.(ABSTRACT TRUNCATED AT 250 WORDS)

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Mumps meningoencephalitis. Prolonged abnormality of cerebrospinal fluid

Cited by 6 publications

References 3 publications

Epidemiology and Clinical Manifestations of Lyme Borreliosis in Childhood

Epidemiology and Clinical Manifestations of Lyme Borreliosis in Childhood

Abstract

Die prolongierte abakterielle Meningitis: Klinische Aspekte und Liquorbefunde

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