Pediatric stroke related to Lyme neuroborreliosis: Data from the Swiss NeuroPaediatric Stroke Registry and literature review.

Monteventi, O; Steinlin, Maja; Regényi, Mária; Roulet-Perez, E; Weber, P; Fluss, J (2018). Pediatric stroke related to Lyme neuroborreliosis: Data from the Swiss NeuroPaediatric Stroke Registry and literature review. European journal of paediatric neurology, 22(1), pp. 113-121. Elsevier 10.1016/j.ejpn.2017.10.010

[img] Text
1-s2.0-S1090379817301794-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (747kB) | Request a copy


Cerebrovascular complications of Lyme neuroborreliosis (LNB) are poorly documented in the paediatric population.


We performed a retrospective analysis from prospectively registered cases of acute ischemic stroke (AIS) from the Swiss NeuroPaediatric Stroke Registry (SNPSR) from 2000 to 2015. Only cases with serologically confirmed LNB were included. In addition, a literature review on paediatric stroke cases secondary to Lyme neuroborreliosis in the same time frame was performed.


4 children out of 229 children with arterial ischemic childhood stroke and serologically confirmed LNB were identified in the SNPSR giving a global incidence of 1.7%. Median age was 9.9 years. A prior history of tick bites or erythema migrans (EM) was reported in two cases. Clinical presenting signs were suggestive of acute cerebellar/brainstem dysfunction. On imaging, three children demonstrated a stroke in the distribution of the posterior inferior cerebellar artery. The remaining fourth child had a "stroke-like" picture with scattered white matter lesions and a multifocal vasculitis with prominent basilar artery involvement. Lymphocytic pleocytosis as well as intrathecal synthesis of Borrelia burgdorferi antibodies were typical biological features. Acute intravenous third generation cephalosporins proved to be effective with rapid improvement in all patients. No child had recurrent stroke. Data from the literature concerning eight patients gave similar results, with prominent posterior circulation stroke, multifocal vasculitis and abnormal CSF as distinctive features.


Lyme Neuroborreliosis accounts for a small proportion of paediatric stroke even in an endemic country. The strong predilection towards posterior cerebral circulation with clinical occurrence of brainstem signs associated with meningeal symptoms and CSF lymphocytosis are suggestive features that should rapidly point to the diagnosis. This can be confirmed by appropriate serological testing in the serum and CSF. Clinicians must be aware of this rare neurological complication of Lyme disease that demands specific antibiotic treatment.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Steinlin, Maja and Regényi, Mária


600 Technology > 610 Medicine & health








Sinthuja Rajkumar

Date Deposited:

16 Apr 2018 15:42

Last Modified:

03 Nov 2019 22:57

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Cerebrovascular Child Lyme Neuroborreliosis Pediatric stroke Vasculitis




Actions (login required)

Edit item Edit item
Provide Feedback