Lyme neuroborreliosis—epidemiology, diagnosis and management

Koedel, Uwe; Fingerle, Volker; Pfister, Hans‐Walter

doi:10.1038/nrneurol.2015.121

Cited by 224 publications

(228 citation statements)

References 158 publications

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“…The diagnosis of neuroinvasive Lyme disease was made based on serology using a two-tiered method 14. Screening is performed using ELISA.…”

Section: Discussionmentioning

confidence: 99%

Woman with lower back pain, SIADH and a twist of Lyme

Salaami¹,

Manning

2018

BMJ Case Reports

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A 62-year-old woman was admitted with a 3-week history of atraumatic bilateral lower back pain, progressive ascending flaccid paralysis, hyponatraemia and constipation. She was otherwise in good health with only a recent diagnosis of acute gastroenteritis that preceded her presenting symptoms. Her initial laboratory evaluation was consistent with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) but was otherwise unremarkable. MRI of the spine revealed bilateral diffuse nerve root enhancement from at least C6 to the conus level, suggesting an inflammatory process. Lumbar puncture demonstrated high protein (629 mg/dL) with marked pleocytosis (363 cells/mcL) incompatible with albuminocytological dissociation typically seen in Guillain-Barre syndrome. A thorough diagnostic evaluation was undertaken to explore potential infectious, malignant and autoimmune conditions. Lyme disease serology (ELISA and Western Blot, IgM and IgG) was positive leading to a final diagnosis of lymphocytic meningoradiculitis or Bannwarth syndrome.

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“…The diagnosis of neuroinvasive Lyme disease was made based on serology using a two-tiered method 14. Screening is performed using ELISA.…”

Section: Discussionmentioning

confidence: 99%

Woman with lower back pain, SIADH and a twist of Lyme

Salaami¹,

Manning

2018

BMJ Case Reports

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“…Internationally, Lyme disease is seen in the environmentally similar areas of Scandinavia and Central Europe (mainly Austria, Slovenia and Germany), the Northeast and Upper Mid-west USA, and some parts of Asia 5. There are no accurate international data on incidence of neuroborreliosis, and obtaining such data is challenging due to variation in case definition.…”

Section: Introductionmentioning

confidence: 99%

Lyme disease: diagnosis and management

et al. 2018

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Lyme disease (borreliosis) is a tick-borne bacterial infection caused by the spirochaete Borrelia burgdoferi, transmitted by hard-backed Ixodes ticks. Actual numbers of cases are increasing and it appears that the distribution across the UK is widening; however, it occurs most frequently in area of woodland, with temperate climate. It typically presents in mid to late summer. Lyme disease is a multisystem disease. The nervous system is the second most commonly affected system after the skin. Other systemic manifestations, such as carditis, keratitis, uveitis and inflammatory arthritis, rarely occur in European Lyme disease. In 2018, the National Institute for Health and Care Excellence has updated its guidelines on the diagnosis and management of Lyme disease. Here, we highlight important aspects of this guidance and provide a more detailed review of the clinical spectrum of neuroborreliosis, illustrated by cases we have seen.

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“…Outros sintomas de envolvimento precoce do sistema nervoso central, como encefalomielite e mielite são raros (< 5%). 6 As formas de mielite relatadas na literatura são caracterizadas pelo envolvimento medular transverso e longitudinal. 7,8 …”

Section: Introductionunclassified

Mielite Extensa como Manifestação de Neuroborreliose

Brás¹,

Marques²,

Santiago³

et al. 2016

Acta Med Port

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RESUMOAs manifestações neurológicas na doença de Lyme ocorrem em 3% -12% dos doentes, sendo a forma de apresentação mais comum a meningorradiculite. Outros sintomas de envolvimento do sistema nervoso central, como encefalomielite ou mielite são raros (< 5%). Descreve-se um caso clínico de um homem de 66 anos com uma mielite transversa extensa, de instalação subaguda, secundária a infeção por Borrelia burgdorferi. O doente foi submetido a terapêutica antibiótica dirigida, com uma boa evolução clínica. A raridade na forma de apresentação clínica e imagiológica deste caso, tendo como base uma doença infecciosa tratável, destaca a importância da sua inclusão no diagnóstico diferencial da mielite transversa longitudinalmente extensa. Palavras-chave: Mielite Transversa; Neuroborreliose de Lyme. ABSTRACTNeurological manifestations of Lyme disease are reported in 3% -12% of patients, with the most common form of presentation being meningoradiculitis. Other symptoms involving the central nervous system, such as myelitis or encephalitis, are rare (< 5 %). We report a case of a 66-year-old male, with a subacute extensive transverse myelitis, secondary to Borrelia burgdorferi infection. The patient underwent antibiotic therapy filed for neuroborreliosis with a good clinical outcome. The rareness in clinical symptoms and imaging presentation, based on a treatable infectious disease, highlights the importance of the inclusion of neuroborreliosis in the differential diagnosis of longitudinally extensive transverse myelitis. Keywords: Lyme Neuroborreliosis; Myelitis, Transverse. INTRODUÇÃOA doença de Lyme é uma infeção multissistémica causada pela picada da carraça (espécie Ixodes ricinus) infetada pela espiroqueta Borrelia burgdorferi sensu latu. A picada provoca uma resposta inflamatória local, caracterizada por uma erupção cutânea, designada por eritema migrans. Apenas em 20% -30% dos casos é relatada a presença do eritema migrans. 1 A disseminação sistémica é acompanhada de sintomas pseudogripais, 2 podendo posteriormente ser acompanhada de envolvimento do sistema nervoso (síndrome Garin-Bujadoux-Bannwarth) 3 em 10% -15%, articular em 10% e cardíaco em 1% -2% dos casos. 4 Os sintomas neurológicos ocorrem geralmente entre a primeira e a décima segunda semana após picada da carraça infetada. 1,5 As manifestações neurológicas na doença de Lyme precoce (primeiros seis meses) ocorrem em 3% -12% dos doentes, sendo a meningorradiculite a forma de apresentação mais comum, seguida da meningite linfocítica. Outros sintomas de envolvimento precoce do sistema nervoso central, como encefalomielite e mielite são raros (< 5%). 6 As formas de mielite relatadas na literatura são caracterizadas pelo envolvimento medular transverso e longitudinal. 7,8 CASO CLÍNICOApresentamos o caso clínico de um homem de 66 anos de idade, raça caucasiana, com um quadro subagudo (duas semanas de evolução) e progressivo de fraqueza dos membros inferiores associado a retenção urinária e fecal. O doente tinha insuficiência cardíaca congestiva, fibrilhação auric...

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Lyme neuroborreliosis—epidemiology, diagnosis and management

Cited by 224 publications

References 158 publications

Woman with lower back pain, SIADH and a twist of Lyme

Woman with lower back pain, SIADH and a twist of Lyme

Lyme disease: diagnosis and management

Mielite Extensa como Manifestação de Neuroborreliose

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