Borrelia nervpåverkan

Common and uncommon neurological manifestations of neuroborreliosis leading to hospitalization

  • Research article
  • Open access
  • Published:
  • Philipp Schwenkenbecher1,
  • Refik Pul1,
  • Ulrich Wurster1,
  • Josef Conzen2,
  • Kaweh Pars1,
  • Hans Hartmann3,
  • Kurt-Wolfram Sühs1,
  • Ludwig Sedlacek4,
  • Martin Stangel1,
  • Corinna Trebst1 &
  • …
  • Thomas Skripuletz1

BMC Infectious Diseasesvolume 17, Article number: 90 () Cite this article

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Abstract

Background

Neuroborreliosis represents a relevant infectious disease and can cause a variety of neurological manifestations. Different stages and syndromes are described and atypical symptoms can result in diagnostic delay or misdiagnosis. The aim of this retrospective study was to define the pivotal neurological deficits in patients with neuroborreliosis that were the reason for admission in a hospital.

Methods

We retrospectively evaluated data of patients with neuroborreliosis. Only patients who fulfilled the diagnostic criteria of an intrathecal antibody production against Borrelia burgdorferi were included in the study.

Results

Sixty-eight patient

  • borrelia nervpåverkan

    • Oncohema Key

    NEUROBORRELIOSIS: NERVOUS SYSTEM INVOLVEMENT WITHBORRELIASPECIES


    JOHN J. HALPERIN, SVEN BERGSTRÖM, AND GARY P. WORMSER


    Relapsing fever and Lyme disease, infections most commonly acquired through bites of hematophagous arthropods, are caused by spirochetes in the genus Borrelia. Both can involve the nervous system; meningitis and cranial neuritis occur commonly. Relapsing fevers may cause more severe manifestations, leading in extreme cases to brain microhemorrhages and focal central nervous system (CNS) damage. Focal CNS involvement is quite rare in Lyme borreliosis; the details of its pathophysiologic mechanisms, although clearly inflammatory, remain to be elucidated.


    RELAPSING FEVER


    There are approximately 20 different borrelial species capable of causing relapsing fever (Fig. ), an illness characterized by recurrent, several-day bouts of fever separated by periods of relative well-being. The episodic nature of this infection is due to sequential evasion of the host’s adaptive immunologic responses. In untreated patients, up to 10 to 15 recurrences may develop, although usually, the number is 1 to 3.



    Epidemiolo

    Neuroborreliosis is defined as the neurological manifestations of Lyme disease (general and extra-neurological aspects are dealt with in a separate chapter).

    Lyme disease or borreliosis is a systemic infection with certain Borrelia (tick-borne spirochetosis) whose manifestations are usually limited to the cutaneous and articular spheres. More rarely (≈ 10% of cases), it fryst vatten complicated bygd cardiac and/or neurological manifestations, which man it particularly serious.

    As a rule, the early neurological complications of borreliosis have an excellent spontaneous prognosis, whereas late-onset disease usually evolves adversely in absence of treatment.

    As the most suggestive cutaneous and articular manifestations of the disease can be frustrating, they are not always funnen in the patient's clinical history. In addition, neuroborreliosis is highly protean, and very difficult to diagnose in the absence of documented Lyme disease.

    Clinical

    Neuroborreliosis is highly protean however, the most classic clinical pictures, isolated or associated, are&#;:

    • Early infection (manifestation 1 to 10 weeks after erythema migrans):
      • Meningoradiculitis improving spontaneously after a f