Lyme-Borreliose : Haut- und Nervensystem

Lyme borreliosis is the most frequent tick-borne disorder. Its discovery 25 years ago was a mile-stone in the field of infectious diseases. Children are especially prone to tick bites and therefore at special risk for Lyme borreliosis. Lyme borreliosis is a multisystem disorder which affects the skin in three-fourths of the cases (mainly erythema migrans) and the central nervous system and the joints clearly less frequently. In childhood acute peripheral facial nerve palsy and aseptic meningitis dominate the clinical spectrum of neuroborreliosis. Lyme borreliosis is a clinical diagnosis which is established on the basis of the history, the clinical findings, and the antibody results. Specific antibody diagnosis is complicated by the problem of insufficient sensitivity and specificity. The consequence is the risk of overdiagnosis and overtreatment. In neuroborreliosis the CSF findings are especially helpful. CSF pleocytosis is mandatory for the diagnosis of neuroboreliosis. Early and effective antibiotic treatment guarantees a good prognosis of Lyme borreliosis with quick resolvement of symptoms. Long-term sequelae of neuroborreliosis have not been proved in children, but cannot yet be excluded.