Case Report

Papilledema as the Sole Manifestation of Neuroborreliosis

Table 1

Summary of the literature review of ocular manifestations of Lyme disease.

CitationPatient detailsInitial symptomsTime from initial symptoms to ocular symptoms (weeks)Ocular symptomsOcular signsAntibody to B. burgdorferiAntibody to B. burgdorferiOpening pressure (cm H2O)CSF white cellsBrain MRI findingsTreatmentOutcome
Bands on WBCSF/serum ratio

Rothermel et al. [11]An 8-year-old maleHeadache8Decreased visionSwollen discs with elevation of the retina10/10 IgG bandsNot doneNormal0NormalCeftriaxoneResolution of symptoms
A 16-year-old maleKnee arthritis28Blurred vision of the left eyeSwollen optic disc, central scotoma8/10 IgG bandsNot doneNormal<10NormalCeftriaxoneResolution of symptoms
A 13-year-old girlFever, headache, and neck pain3Horizontal diplopia and eye painBilateral papilledema, sixth nerve palsy, and decreased visual acuity7/10 IgG bandsIgG 1.426082NormalCeftriaxoneResolution of symptoms
An 11-year-old maleRash, headaches, vomiting, and fever2.5Double visionPhotophobia and bilateral sixth and seventh nerve palsies8/10 IgG bands<1 for IgG, IgM, and IgA573Ceftriaxone and methylprednisoloneImprovement in symptoms with residual sixth nerve palsy

Ezequiel et al. [7]A 9-year-old maleHeadache, pallor, photophobia, and phonophobiaPapilledemaPositivePositive IgG and IgM5030NormalCeftriaxoneResolution of symptoms

Kan et al. [4]An 8-year-old femaleHeadaches, vomiting, and diplopiaDiplopiaPapilledema and left sixth nerve palsyPositivePositive CSF antibodies32115Dural enhancementCeftriaxone and acetazolamidePapilledema resolved, and mild sixth nerve palsy remained