Any of the cranial nerves can be affected but sixth and seventh nerve palsy are the most frequent. Clinical signs suggestive of meningitis have been described in neuroborreliosis but in fact they are uncommon in adults. In summary, pain is the presenting symptom in all cases. Nevertheless, correct diagnosis and treatment are necessary at this stage to avoid further complications. Early borreliosis in children Early neuroborreliosis in children is even more challenging for the medical practitioner.
Symptoms are different than in adults.
Painful radiculitis is not common but facial palsy is frequent. Although fever is not common, the fear of a bacterial menigitis will often prompt CSF examination. Serologic tests performed in serum and CSF will lead ultimately to the recognition of a Borrelia infection. These forms rarely coexist and their frequency differs from country to country. Lyme arthritis is the most frequent form of late borreliosis in the USA but is less common in Europe.