Lyme Disease Radiculopathy in a Child
Lyme disease can affect the nervous system in children.
A 10-year-old boy developed painful cervical radiculitis.
MRI findings suggested nerve root inflammation due to Lyme disease.
Lyme disease can affect the nervous system and may lead to radiculopathy, radiculitis, or radiculoneuritis in some patients.
Neurologic Lyme disease in children may present with nerve pain, weakness, tingling, dizziness, or radiating symptoms involving the nerve roots.
Child Presented With Neck Pain and Radiculitis
A 10-year-old boy presented with fatigue, posterior lower neck pain, and a low-grade fever of 100.8.
“The soft tissues of the posterior neck and upper back were tender with allodynia,” wrote Baker and colleagues in the American Journal of Emergency Medicine.2
The magnetic resonance imaging (MRI) of the cervical spine demonstrated “questionable” nerve root enhancement at levels C5-C6 and C6-C7 consistent with radiculitis.
The child was initially discharged from the emergency room with a diagnosis of cervical radiculitis due to presumed viral infection.
Lyme Disease Diagnosed Two Days Later
Two days later, the child was diagnosed with Lyme disease with positive IgM and IgG Western blot testing.
The patient’s symptoms resolved following treatment with oral doxycycline.
The authors emphasized that radiculoneuritis associated with Lyme disease is not a new phenomenon.
“In US children, meningitis and cranial nerve palsy are relatively common in neuroborreliosis, while radiculoneuritis is rare,” wrote the authors.2
Neurologic Lyme Disease May Be Difficult to Recognize
The authors explained that neuroborreliosis may be easier to recognize when facial nerve palsy or meningitis occur together with radiculitis, since these are more classically associated with Lyme disease.
Children with Lyme radiculopathy or radiculitis may instead present with non-specific neurologic symptoms including pain, allodynia, weakness, tingling, dizziness, gait problems, or radiating nerve discomfort.
Because symptoms may overlap with viral illness, orthopedic injury, or inflammatory neurologic conditions, diagnosis may sometimes be delayed.
For additional discussion, see 9 cases of children in France with Lyme neuroborreliosis.
Authors Recommend Lyme Testing for Painful Radiculitis
“Any patient with painful radiculitis and plausible exposure to potentially infected ticks should have Lyme testing,” the authors concluded.
FAQ: Lyme Disease and Radiculopathy
Can Lyme disease cause radiculopathy?
Yes. Lyme disease may affect nerve roots and lead to radiculopathy, radiculitis, or radiculoneuritis.
What are symptoms of Lyme radiculopathy?
Symptoms may include nerve pain, weakness, numbness, tingling, burning sensations, dizziness, neck pain, or radiating pain.
Related Articles:
Stomach pain can be a symptom of Lyme disease
References:
- Cavalli E, Mammana S, Nicoletti F, Bramanti P, Mazzon E. The neuropathic pain: An overview of the current treatment and future therapeutic approaches. Int J Immunopathol Pharmacol. 2019;33:2058738419838383. doi:10.1177/2058738419838383
- Baker AL, Mannix R, Baker AH. Radiculoneuritis due to Lyme disease in a North American child. Am J Emerg Med. 2022. doi:10.1016/j.ajem.2022.03.063
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
