All Posts Tagged With: "Lyme neuroborreliosis"

Linda’s Comment:   Bell’s palsy and Lyme neuroborreliosis are the two most common diagnoses in patients with peripheral facial palsy in areas endemic for Borrelia burgdorferi.\

Excerpt:

CONCLUSIONS: We found that the time of the year, associated neurological
symptoms and mononuclear pleocytosis were strong predictive factors for
Lyme neuroborreliosis as a cause of peripheral facial palsy in an area
endemic for Borrelia.

Linda’s comment  Reversible dementias are rare and account for approximately 1.5% of all dementias. The most frequent etiology is represented by neurosurgical causes such as benign tumours, adult chronic hydrocephalus (so-called « normal pressure » hydrocephalus) or subdural hematoma, which are easily revealed by neuroimaging.

Link: http://www.medfetch.com/r/39715/21690030/

Excerpt:

Reversible dementias are rare and account for approximately 1.5% of all
dementias. The most frequent etiology is represented by neurosurgical
causes such as benign tumours, adult chronic hydrocephalus (so-called
« normal pressure » hydrocephalus) or subdural hematoma, which are
easily revealed by neuroimaging.

Linda’s comment:  CXCL13 in CSF could be an important component for diagnosing Lyme neuroborreliosis (LNB),  Don’t you just love these studies.  WHY are they not doing the follow through of this deadly disease…???

Link: http://www.ncbi.nlm.nih.gov/pubmed?term=Discriminating%20Lyme%20neuroborreliosis%20from%20other%20neuro-inflammatory%20diseases

Excerpt:

In the diagnosis of LNB elevated
levels of CXCL13 can aid the diagnosis, but levels should be interpreted
with care.

Linda’s comment:  There are so many different types of European Lyme Borreliosis in whom borreliae were isolated from the blood are rare and nearly exclusively is limited to those ith solitary or mltiple erythema migrans.

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21153429&retmode=ref&cmd=prlinks 

Excerpt:

CONCLUSIONS: In European patients with Lyme borreliosis, borreliae can be
cultured from the blood not only early in the course of the disease but also
occasionally later during disease progression.

We have to somehow get these hospitals trained to recognize Lyme Neuroborreliosis….it can kill and go undiagnosed…..This case history is quiet disturbing…

Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994358/?tool=pubmed

Excerpt:

We report a case of neuroborreliosis with severe bilateral recurrent nerve
palsy, which had to be treated at an intensive care unit because of acute
respiratory distress.

Case history

A 66-year-old woman was transferred to our facility from a local hospital.
Her only remarkable prior condition was diabetes mellitus, for which she was
on oral medication. She did not recall a tick bite or any skin changes
during the last months.

Excerpt:

BACKGROUND AND PURPOSE

Neuroborreliosis is a rare cause of stroke in children. We aim here to demonstrate the diagnostic value of gadolinium-enhanced magnetic resonance imaging (MRI) for demonstrating vessel wall abnormality in a child with brainstem stroke.

RESULTS

We report here the case of an 8-year-old boy with cerebral vasculitis and stroke due to Lyme neuroborreliosis. Imaging studies revealed the presence of ischemic lesions in the pons and cerebellum, with focal stenosis of the basilar artery on magnetic resonance angiography and focal gadolinium enhancement of the basilar artery wall. Nine months after treatment, clinical outcome was favorable, with no enhancement of the basilar artery.

CONCLUSIONS

Gadolinium-enhanced MRI provided additional information facilitating the diagnosis of vasculitis in a child with Lyme neuroborreliosis and stroke. The location of vessel wall enhancement was correlated with the topography of the acute infarct, and the lack of vessel lumen obstruction supported the diagnosis of vasculitis rather than any other cause.

Excerpt:

A 36-year-old Japanese woman presented with progressive cerebellar signs and mental deterioration of subacute course after her return from the USA. Her serum antibody to spirochete Borrelia burgdorferi was significantly elevated. A necropsy 4 years after her initial neurological signs revealed multifocal inflammatory change in the cerebral cortex, thalamus, superior colliculus, dentate nucleus, inferior olivary nucleus and spinal cord. The lesions showed spongiform change, neuronal cell loss, astrocytosis and proliferation of activated microglial cells. The internal capsule was partially vacuolated and the spinal cord, notably at the thoracic level, was demyelinated and cavitated in the lateral funiculus. Microglial cells aggregated within and around the spongiform lesions and microglial nodules were present in the medulla oblongata. Use of Warthin-Starry stain demonstrated silver-impregnated organisms strongly suggesting B. burgdorferi in the central nervous tissues. The dentate nucleus and inferior olivary nucleus showed the most advanced lesions with profound fibrillary gliosis. Occlusive vascular change was relatively mild, and fibrous thickening of the leptomeninges with lymphocyte infiltrates was localized in the basal midbrain. The ataxic symptoms were due to the dentate and olivary nucleus lesions and mental deterioration was attributable to the cortical and thalamic lesions. Spongiform change, neuronal cell loss, and microglial activation are characteristic pathological features in the present case. The cerebellar ataxia and subsequent mental deterioration are unusual clinical features of Lyme neuroborreliosis. Spirochete B. burgdorferi can cause focal inflammatory parenchymal change in the central nervous tissues and the present case may be an encephalitic form of Lyme neuroborreliosis.

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21188224&retmode=ref&cmd=prlinks

Excerpt:

Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of
23 patients submitted to strict criteria for case selection of the Centers
for Disease Control and Prevention employing a two-tier test to detect
antibodies to Borrelia burgdorferi at a single institution. One patient had
symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of
early infection; and another had symptomatic small fiber sensory neuropathy,
distal polyneuropathy, dysautonomia, and serological evidence of late
infection. In the remaining patients symptoms initially ascribed to Lyme
disease were probably unrelated to B. burgdorferi infection. Our findings
suggest early susceptibility and protracted involvement of the nervous
system most likely due to the immunological effects of B. burgdorferi
infection, although the exact mechanisms remain uncertain.

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20666055&retmode=ref&cmd=prlinks

Excerpt:

Lyme disease is a multisystem infectious disease, endemic in
parts of Europe, including the West of Ireland. Neurological
manifestions (neuroborreliosis) are variable. Presenting
neurological syndromes include meningitis, cranial neuropathies,
myeloradiculitis and mononeuritis multiplex. A lack of
specificity in serological diagnosis may add to diagnostic
confusion. We reviewed thirty cases of acute Lyme disease in the
West of Ireland and found neurological syndromes in 15 (50%),
with painful radiculopathy (12 patients; 80%) and cranial
neuropathy (7 patients; 46%) occurring frequently.
Neuroborreliosis needs to be considered in the differential
diagnosis of these neurological syndromes in the appropriate
clinical context.

Full article: http://www.springerlink.com/content/e44520883374r21k/

Excerpt:

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.