Acute transverse myelitis in Lyme neuroborreliosis
By Linda on Jul 2, 2010 in Infections | comments(0)
Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20505978&retmode=ref&cmd=prlinks
Excerpt:
INTRODUCTION: Acute transverse myelitis (ATM) is a rare disorder
(1-8 new cases per million of population per year), with 20% of
all cases occurring in patients younger than 18 years of age.
Diagnosis requires clinical symptoms and evidence of inflammation
within the spinal cord (cerebrospinal fluid and/or magnetic
resonance imaging). ATM due to neuroborreliosis typically
presents with impressive clinical manifestations.
CASE PRESENTATION: Here we present a case of Lyme
neuroborreliosis-associated ATM with severe MRI and CSF findings,
but surprisingly few clinical manifestations and late conversion
of the immunoglobulin G CSF/blood index of Borrelia burgdorferi
sensu lato.
CONCLUSION:
Clinical symptoms and signs of neuroborrelial ATM may be minimal,
even in cases with severe involvement of the spine, as shown by
imaging studies. The CSF/blood index can be negative in the early
stages and does not exclude Lyme neuroborreliosis; if there is
strong clinical suspicion of Lyme neuroborreliosis, appropriate
treatment should be started and the CSF/blood index repeated to
confirm the diagnosis.
