Neuroborreliosis: A single-hospital series of 7 cases

Gómez-Eguílaz, M.; Gómez-Cerquera, Juan Manuel; Calvo-Pérez, L.; Oteo, José Antonio

doi:10.1016/j.nrleng.2014.03.009

Cited by 1 publication

(2 citation statements)

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“…[ 10 11 12 13 14 15 ] One Spanish single-center series reports seven cases: one patient presented with meningoencephalitis, two with brachial plexopathy, two with radiculopathy, and one with cranial nerve palsy. [10] Another study collected patients with a positive serology and neurological symptoms in the South West of England: 22 cases were recorded during the 5-year study period including patients with facial palsy, radiculopathy and meningoencephalitis, and two patients experiencing peripheral sensory manifestations. [11] Isolated nerve palsy (facial palsy, left abducens palsy) has also been reported,[ 12 13 14 ] as well as Parsonage-Turner syndromes.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, antibiotic treatment led to a favorable outcome in almost all cases, as reported in other series. [ 10 11 ] According to both European and American guidelines, patients with early neuroborreliosis (meningitis, radiculopathy) should be treated with intravenous ceftriaxone (2 g/for at least 2 weeks). If a patient is intolerant to b-lactam antibiotics, doxycycline can be used.…”

Section: Discussionmentioning

confidence: 99%

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Confirmed cases of Neuroborreliosis with involvement of peripheral nervous system

et al. 2020

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The manifestations of borreliosis in the peripheral nervous system (PNS) remain poorly described. As the symptoms of neuroborreliosis can be reversed with timely introduction of antibiotics, early identification could avoid unnecessary axonal loss. Our aim was to describe the characteristics of confirmed neuroborreliosis cases involving the PNS diagnosed between 2007 and 2017 in our neuromuscular disease center in a nonendemic area (La Pitié-Salpêtrière Hospital, Paris, France). Neuroborreliosis was defined as follows: compatible neurological symptoms without other cause of neuropathy; cerebrospinal fluid and serum analysis (positive serological tests with ELISA, confirmed by Western Blot); and improvement of symptoms with adapted antibiotherapy. All the patients consulting in our center between 2007 and 2017 underwent electrophysiological study. Sixteen confirmed cases of neuroborreliosis involving the PNS were included: 10 cases of meningoradiculoneuritis, 4 of axonal neuropathy, and 2 of demyelinating neuropathy (one acute and one chronic). Only 4 (25%) patients reported tick bites. Meningoradiculoneuritis was characterized by lymphocytic meningitis, intense pain, cranial nerve palsy, and contrast enhancement of nerve roots on imagery. The patients with axonal neuropathy presented sensory symptoms with intense pain but no motor deficit and meningitis was rare. Nerve biopsy of 1 patient revealed lymphocytic vasculitis. Electrophysiological testing showed sensory or sensorimotor axonal neuropathy (3 subacute and 1 chronic) of the lower limbs, with asymmetrical neuropathy in 1 patients, symmetrical neuropathy in one and monomelic sensory mononeuritis multiplex in another. We also found 1 case of acute demyelinating neuropathy, treated with antibiotherapy and immunoglobulins, and 1 chronic demyelinating neuropathy. Overall, diaphragmatic paralysis was frequent (18.6%). Antibiotherapy (mostly ceftriaxone 3–4 weeks) resulted in symptom resolution. This series gives an updated overview of the peripheral complications of neuroborreliosis to help identify this disease so that timely treatment could avoid axonal loss.

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