Inflammation in the Pathogenesis of Lyme Neuroborreliosis

Ramesh, Geeta; Didier, Peter J.; England, John D.; Santana-Gould, Lenay; Doyle-Meyers, Lara A.; Martin, Dale S.; Jacobs, Mary B.; Philipp, Mario T.

doi:10.1016/j.ajpath.2015.01.024

Cited by 76 publications

(78 citation statements)

References 79 publications

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“…This causes pathological alterations similar to those seen in human LNB. Dexamathasone prevented these pathological alterations although Borelliae persisted [42]. This could explain the alternating disease course with a tendency to improvement in a case report on chronic CNS-LNB, which was treated with corticosteroids and azathioprine for 2.5 years.…”

Section: Discussionmentioning

confidence: 99%

Secondary dementia due to Lyme neuroborreliosis

Kristoferitsch

Aboulenein-Djamshidian

Jecel

et al. 2018

Wien Klin Wochenschr

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SummaryDementia-like syndromes are rare manifestations of Lyme neuroborreliosis. The clinical patterns are summarized using our own cases and case reports from the literature, which were diagnosed as definite Lyme neuroborreliosis according to the European guidelines. The cases disclose signs of subcortical dementia that occur more rapidly than in patients suffering from primary dementia. Gait disturbances early in the disease course is another frequently observed characteristic feature. The response to 2–4 weeks of antibiotic treatment with ceftriaxone was excellent. There were no indications for a prolonged antibiotic treatment. It is essential to be aware of this manifestation of Lyme neuroborreliosis, because early antibiotic treatment will prevent permanent sequelae that may occur throughout the further course of the untreated disease.

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Section: Discussionmentioning

confidence: 99%

Secondary dementia due to Lyme neuroborreliosis

Kristoferitsch

Aboulenein-Djamshidian

Jecel

et al. 2018

Wien Klin Wochenschr

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“…B. burgdorferi may be diagnosed as a persistent infection with immune suppressant and evasive capabilities,12 or there may be a postinfectious process. In either case, the psychiatric symptoms are associated with an immune-mediated process 13–17…”

Section: Introductionmentioning

confidence: 99%

Suicide and Lyme and associated diseases

Bransfield¹

2017

NDT

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PurposeThe aim of this paper is to investigate the association between suicide and Lyme and associated diseases (LAD). No journal article has previously performed a comprehensive assessment of this subject.IntroductionMultiple case reports and other references demonstrate a causal association between suicidal risk and LAD. Suicide risk is greater in outdoor workers and veterans, both with greater LAD exposure. Multiple studies demonstrate many infections and the associated proinflammatory cytokines, inflammatory-mediated metabolic changes, and quinolinic acid and glutamate changes alter neural circuits which increase suicidality. A similar pathophysiology occurs in LAD.MethodA retrospective chart review and epidemiological calculations were performed.ResultsLAD contributed to suicidality, and sometimes homicidality, in individuals who were not suicidal before infection. A higher level of risk to self and others is associated with multiple symptoms developing after acquiring LAD, in particular, explosive anger, intrusive images, sudden mood swings, paranoia, dissociative episodes, hallucinations, disinhibition, panic disorder, rapid cycling bipolar, depersonalization, social anxiety disorder, substance abuse, hypervigilance, generalized anxiety disorder, genital–urinary symptoms, chronic pain, anhedonia, depression, low frustration tolerance, and posttraumatic stress disorder. Negative attitudes about LAD from family, friends, doctors, and the health care system may also contribute to suicide risk. By indirect calculations, it is estimated there are possibly over 1,200 LAD suicides in the US per year.ConclusionSuicidality seen in LAD contributes to causing a significant number of previously unexplained suicides and is associated with immune-mediated and metabolic changes resulting in psychiatric and other symptoms which are possibly intensified by negative attitudes about LAD from others. Some LAD suicides are associated with being overwhelmed by multiple debilitating symptoms, and others are impulsive, bizarre, and unpredictable. Greater understanding and a direct method of acquiring LAD suicide statistics is needed. It is suggested that medical examiners, the Centers for Disease Control and Prevention, and other epidemiological organizations proactively evaluate the association between LAD and suicide.

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“…The prodrome of pain in this patient is consistent with an early radiculitis, followed by evolution into a poliomyelitis-myelitis syndrome. The mechanism of neurologic involvement remains undefined, although an inflammatory component accentuates the damage caused by the acute infection [8]. Nevertheless, antibiotics are the mainstay of treatment and in our clinical experience, anti-inflammatory therapy is not required.…”

Section: Discussionmentioning

confidence: 91%