Neurologic Complications of Lyme Disease

This article reviews the symptomatology, diagnosis, and treatment of neuroborreliosis. RECENT FINDINGS The most recent guidelines for the diagnosis and treatment of Lyme disease were published in 2020 by the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology. SUMMARY The most common neurologic complications of Lyme disease are cranial neuritis (most often a unilateral or bilateral facial nerve palsy), meningitis, and radiculoneuritis/mononeuropathy multiplex. Testing for Lyme disease begins with an enzyme-linked immunosorbent assay (ELISA). If the ELISA is positive or borderline, Western blots should be performed for both IgM and IgG antibodies. As a general rule, in infectious diseases, an IgM antibody response is followed by an IgG antibody response. A central nervous system infection has either a CSF pleocytosis or pathogen-specific intrathecal antibody production. Lyme meningitis, cranial neuropathy, radiculoneuropathy, or other peripheral nervous system manifestations are treated with oral doxycycline or IV ceftriaxone, cefotaxime, or penicillin G. No additional antibiotic therapy is indicated for patients with posttreatment Lyme disease syndrome or patients with concern for chronic Lyme disease with no evidence of previous or current Lyme infection.
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research

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is the most common tick-borne illness in the USA and Europe. Pathogens involved include Borrelia burgdorferi in the USA and B. afzelii and B. garinii in Europe. The characteristic rash of erythema migrans occurs in 70 –80% of patients. Neurological disease, including facial palsy, meningo-encephalitis, aseptic meningitis and polyradiculopathy, occurs in 10–15%. Cardiac disease, primarily manifest as heart block, is seen in 1–4%. Arthritis is a late complication in about 30% of untreated patients.
Source: Medicine - Category: Internal Medicine Authors: Tags: Bacterial infections Source Type: research
FINDINGSA UCLA study suggests that many physicians may not have the knowledge or training to properly recognize how Lyme disease appears on the skin of Black patients. The disease, caused by the tick-borne Borrelia bacterium, generally begins with a bull ’s-eye–shaped rash on the skin, along with fever, headache, chills and muscle pain; if not diagnosed promptly and treated with antibiotics, it can lead to more severe and long-lasting symptoms.UCLA ’s Dr. Dan Ly found that approximately 1 in 3 Black patients who were newly diagnosed with Lyme disease already had related neurological complications such as ...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
CONCLUSION: The majority of the cases involved meningoradiculitis but other, less common, neurological conditions have been described. The clinical signs suggestive of meningitis are not very marked and might delay the diagnosis.PMID:34509348 | DOI:10.1016/j.arcped.2021.08.001
Source: Archives de Pediatrie - Category: Pediatrics Authors: Source Type: research
Vaccine. 2021 Mar 31:S0264-410X(21)00363-7. doi: 10.1016/j.vaccine.2021.03.059. Online ahead of print.ABSTRACTCurrently there is no human vaccine against Lyme borreliosis, and most research focuses on recombinant protein vaccines, as such a vaccine has been proven to be successful in the past. The expression of recombinant antigens in meningococcal Outer Membrane Vesicles (OMVs), with the OMV functioning both as adjuvant and delivery vehicle, greatly enhances their potential. Immunization studies in mice have shown that OMV-based vaccines can protect against various pathogens and an OMV-based meningococcal vaccine is appro...
Source: Vaccine - Category: Allergy & Immunology Authors: Source Type: research
Conclusions: The Rule of 7’s accurately identified children with meningitis at low-risk for Lyme meningitis for whom clinicians should consider outpatient management while awaiting Lyme disease test results.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
Lyme neuroborreliosis can cause a variety of neurological manifestations. European children usually present facial nerve palsy, other cranial nerve palsies and aseptic meningitis.
Source: Italian Journal of Pediatrics - Category: Pediatrics Authors: Tags: Case report Source Type: research
Abstract Borrelia burgdorferi, the causative agent of Lyme disease, is transmitted by the bite of an infected tick. Once inoculated into the host dermis, it disseminates to various organs including distant skin sites, the heart, the joint and the nervous system. Most humans will develop an early skin manifestation called erythema migrans at the tick bite site. This can be followed by symptoms such as carditis, neuritis, meningitis, or arthritis if not treated. A specific mouse strain, C3H/HeN develops arthritis with B. burgdorferi infection whereas another strain, C57BL/6, develops minimal to no arthritis. Neither...
Source: Journal of Immunology - Category: Allergy & Immunology Authors: Tags: J Immunol Source Type: research
Pediatric bilateral facial nerve paralysis (FNP) is a rare condition, representing less than 2% of all cases of FNP. The differential diagnosis of FNP is extensive (ranging from infectious, traumatic, neurologic, to idiopathic) and often can present as a diagnostic challenge. In contrast to unilateral presentation, bilateral FNP presents as a manifestation of serious systemic conditions, including meningitis (infectious and neoplastic), brain stem encephalitis, Guillain-Barre syndrome, sarcoidosis, Lyme disease, human immunodeficiency virus infection, leukemia, and vasculitis. In the evaluation of a child who presents with...
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
We report a case of acute neuroborreliosis that manifested as extended isolated cervical myelitis. Not only the manifestation as isolated myelitis in the early stages of borreliosis represents a rarity, but also the strong contrast between mild clinical symptoms and pronounced imaging findings in this case is remarkable.Case Rep Neurol 2020;12:276 –281
Source: Case Reports in Neurology - Category: Neurology Source Type: research
Preema Sinha, Bhavni Oberoi, Yadvendra S Sirohi, Aradhana Sood, Saikat BhattacharjeeNeurology India 2020 68(4):916-918 Lyme disease is a multi-organ infectious disease caused by the spirochete “Borrelia burgdorferi,” and transmitted by the “Ixodes” tick. Early disseminated Lyme disease can have varied central nervous system manifestations ranging from meningitis to radiculopathy and cranial neuropathy. If not suspected, misdiagnosis or delayed diagnosis can prove to be fatal. Erythema migrans is the most common clinical presentation, thereby, making dermatological examination extremely crucial in e...
Source: Neurology India - Category: Neurology Authors: Source Type: research
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