Nálezy v mozkomíšním moku u dětí s akutním paretickým postižením

Title in English Findings in Cerebrospinal Fluid among Children with Paretic Involvements
Authors

KRBKOVÁ Lenka HOLEČKOVÁ K. BLECHOVÁ Z. MAREŠOVÁ V. LABSKÁ K. ŠTROBLOVÁ H. BEDNÁŘOVÁ J.

Year of publication 2014
Type Article in Periodical
Magazine / Source Česká a Slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Field Epidemiology, infectious diseases and clinical immunology
Keywords cerebrospinal fluid; pleocytosis; peripheral facial palsy; neuroborreliosis; herpes virus
Description Aim: To evaluate cerebrospinal fluid (CSF) findings in children with paretic involvements and to establish the benefit of such examination with a view to aetiological diagnosis. Material and methods: CSF findings among 227 hospitalized children with paretic involvements of the peripheral or central nervous system were evaluated retrospectively. CSF was analysed cytologically and biochemically. Detected were antibodies against neurotropic viruses, Borrelia and viral nucleic acids by means of PCR. Results: Inflammatory changes due to aseptic meningitis were found in 125 (55%) children, elevation of proteins only in nine (4%) children, and CSF examination was negative in the remaining 93 (41%) children. Cytological examination revealed white blood cells with a predominance of lymphocytes (mean 110, median 10). Median CSF protein was 0.4g/l and median CSF glucose was 3.34 mmol/l. Disruption of the blood-CSF barrier was determined in 55/113 (51%) children, while this condition was severe in 9% of the examined children. Borrelial aetiology was confirmed in 52% of the children, while pleocytosis was revealed in 86% of those samples. Viral and mycoplasmal aetiology was proven in 11% of the children only serologically. The aetiology remained unproven in 37% of the children. Conclusion: CSF examination contributed to the diagnosis of paretic involvements in children. Even despite negative meningeal signs in children, spinal tap should be performed to exclude or confirm meningitis. In our geographic conditions, peripheral facial palsy is diagnosed in 95% of children with the predominance of borrelial aetiology. Paretic involvements of other aetiologies occur only rarely.

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