The clinical and epidemiological features of 187 consecutive patients with neuroborreliosis recognized in Denmark over a 6-year period, 1985-1990, are reported from the Department of Infection-Immunology, Statens Seruminstitut, Copenhagen, Denmark. The most common manifestation was a painful lymphocytic meningoradiculitis (Bannwarth’s syndrome), and CNS involvement in early cases was rare. Neuroborreliosis in children showed a different course compared to adults. Headache was considerably more frequent (70%) compared to adults (35%) whereas radicular pain was significantly less common and less severe in children. Clinical signs of meningitis were reported in 38% of children and in only 3% of adults. Facial palsy in 26 of 40 childhood cases was bilateral in only 3, and was unassociated with pain, fever or neck stiffness. The diagnosis is based on inflammatory CSF changes and B. burgdorferi specific intrathecal antibody production. [1]

COMMENT. Neuroborreliosis in children is often less dramatic than in adults and may be insidious with fluctuating headache, loss of appetite, weight loss, slight meningeal signs but rare focal neurologic signs. Similar findings to the experience in Denmark are reported from the United States. [2]