2019 Jan 14. pii: S0929-693X(18)30263-X. doi: 10.1016/j.arcped.2018.11.013. [Epub ahead of print]

Opsoclonus in a child with neuroborreliosis: Case report and review of the literature.


Opsoclonus consists of massive erratic rapid eye jerks. They may occur in isolation or in association with myoclonus and ataxia, i.e., opsoclonus-myoclonus syndrome (OMS). We report the case of a 9-year-old girl who suffered from headaches for several days and was shown to have opsoclonus and left peripheral facial palsy. Work-up excluded the diagnosis of neuroblastoma, but CSF analysis showed aseptic meningitis, and serology for Borrelia burgdorferi (Lyme) was positive. The outcome was favorable with complete regression of symptoms after treatment with ceftriaxone 2g/day for 3 weeks. Although rare, the diagnosis of Lyme neuroborreliosis must be raised in the presence of isolated opsoclonus, particularly if the clinical picture is incomplete and if other features, such as peripheral facial palsy and pleocytosis in the CSF, are present.



To see what Opsoclonus looks like:

Again, researchers shouldn’t be writing that this manifestation is “rare,” because nobody’s truly keeping track of this.  For decades folks have been undiagnosed due to horrifically abysmal testing that misses half of all cases.  

Facial palsy and aseptic meningitis are huge clues for Lyme

Aseptic meningitis is when the lining of the brain becomes inflamed.  In this case, due to a Borrelia burgdorferi (Bb) infection.  This explains the headaches.

577px-Brain_and_Nearby_StructuresBy Alan Hoofring, Public Domain,

As the picture shows, the meninges cover the entire brain so the headache caused by this is going to cover the entire head.  This is what I personally had that took years of antibiotics to rid.  I wondered if there would ever be a day without this type of headache.

I’ve spoken with many Lyme/MSIDS patients who have had exactly the same thing.  It is not rare.  The pain is unbelievable, and ONLY treatment took it away.  Ibuprophen will not touch this Mother one little bit.  CBD, systemic enzymes, NOTHING will touch this if you have a Bb infection.  The infection must be dealt with first.

For those of you with this presentation, please also consider Chiari, especially if you’ve had this type of headache for some time:  Within a week I met numerous Lyme/MSIDS patients with a Chiari diagnosis.

Lyme/MSIDS can cause numerous other eye issues:  The authors described patients with tick-transmitted diseases presenting with the following ophthalmologic findings:

  • Follicular conjunctivitis
  • Periorbital edema and mild photophobia
  • Bell’s palsy, cranial nerve palsies and Horner syndrome
  • Argyll Robertson pupil
  • Keratitis
  • Optic neuritis, papilledema, papillitis and neuroretinitis
  • Myositis of extraocular muscles and dacryoadenitis
  • Episcleritis, anterior and posterior scleritis
  • Anterior, intermediate, posterior and panuveitis
  • Retinal vasculitis, cotton wool spots and choroiditis
  • Retinitis, macular edema and endophthalmitis
Now add Opsoclonus to this growing list





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