NEUROLOGIC MANIFESTATIONS IN CHILDREN WITH NORTH-AMERICAN LYME-DISEASE

To delineate the spectrum of neurologic manifestations and the relativ e frequencies of different syndromes associated with North American Ly me disease, we describe 96 children referred for neurologic problems i n the setting of Borrelia burgdorferi infection. The most frequent neu rologic symptom was headache, and the most common sign was facial pals y. Less common manifestations were sleep disturbance, and papilledema associated with increased intracranial pressure. Signs and symptoms of peripheral nervous system involvement were infrequent. The most commo n clinical syndromes were mild encephalopathy, lymphocytic meningitis, and cranial neuropathy (facial nerve palsy). In contrast with adult p atients with neurologic Lyme disease, meningoradiculitis (Bannwarth's syndrome) and peripheral neuropathy syndromes were rare. However, a '' pseudotumor cerebri-like'' syndrome seems to be unique to North Americ an pediatric Lyme disease.