NEUROBORRELIOSIS WITH EDEMA OF THE OPTIC DISK AND PARALYSIS OF THE NERVUS ABDUCENS

We report on two children (7-year-old girl; 11-year-old boy) with an u nusual manifestation of neuroborreliosis involving the nervus opticus and nervus abducens. Both children had a bilateral oedema of the optic disk and a strabismus convergens caused by paralysis of the 6th crani al nerve. Since, in addition, the children presented with headache, in itially an intracranial tumor was considered but then excluded by magn etic resonance imaging. The cerebrospinal fluid showed a mononuclear p leocytosis,and specific antibodies against Borrelia burgdorferi were d etected in serum and in CSF. These results confirmed the diagnosis of ''neuroborreliosis''. All clinical manifestations disappeared a few da ys to weeks after treatment with intravenous ceftriaxon. Discussion: I n the presence of cranial nerve palsy and optic disk oedema of unknown origin neuroborreliosis may be the correct diagnosis. Isolated involv ement of the eye in the late stage of Lyme borreliosis is distinct fro m neuroborreliosis with cranial nerve involvement.