Child with Lyme disease diagnosed with radiculopathy
“Among the signs and the symptoms connected to the presence of neuropathic pain are allodynia (pain due to a stimulus that does not normally provoke pain), hyperalgesia (an increase in the perception of pain generated by a stimulus that causes pain), and paresthesia (a condition that determines the perception of anomalous sensations comparable to needle bites, tingling, itching, reduced, or even loss of sensitivity),” wrote Cavalli and colleagues in the International Journal of Immunopathology and Pharmacology. 
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
They added, the Magnetic Resonance Imaging (MRI) of the cervical spine showed “questionable” nerve root enhancement at levels C5-C6 and C6-C7 consistent with radiculitis. The child was discharged from the emergency room with a diagnosis of cervical radiculitis due to viral infection.
Two days later, the child was diagnosed with Lyme disease with a positive IgM and IgG western blot test. The patient’s symptoms resolved following treatment with oral doxycycline.
The authors pointed out that radiculoneuritis due to Lyme disease is not new. “In US children, meningitis and cranial nerve palsy are relatively common in neuroborreliosis, while radiculoneuritis is rare,” wrote the authors.²
They added, “Neuroborreliosis is easier to recognize when facial nerve palsy or meningitis are present with radiculitis since these are classically associated with Lyme.”
“Any patient with painful radiculitis and plausible exposure to potentially infected ticks should have Lyme testing,” the authors concluded.
- 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. Jan-Dec 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. Apr 7 2022;doi:10.1016/j.ajem.2022.03.063