Neuroborreliosis is often preceded by the typical symptoms of Lyme disease, which include erythema migrans and flu-like symptoms such as fever and muscle aches. Neurologic symptoms of neuroborreliosis include the meningoradiculitis (which is more common in European patients), cranial nerve abnormalities, and altered mental status. Sensory findings may also be present. Rarely, a progressive form of encephalomyelitis may occur. In children, symptoms of neuroborreliosis include headache, sleep disturbance, and symptoms associated with increased intracranial pressure, such as papilledema. Less common childhood symptoms can include meningitis, myelitis, ataxia, and chorea. Ocular Lyme disease has also been reported, as has neuroborreliosis affecting the spinal cord, but neither of these findings are common.[3]
Diagnosis
Differential diagnosis
A number of diseases can produce symptoms similar to those of Lyme neuroborreliosis. They include:
Diagnosis is determined by clinical examination of visible symptoms.[5] Neuroborreliosis can also be diagnosed serologically to confirm clinical examination via western blot, ELISA, and PCR.[6]
Treatment
In the US, neuroborreliosis is typically treated with intravenous antibiotics which cross the blood–brain barrier, such as penicillins, ceftriaxone, or cefotaxime.[7] One relatively small randomized controlled trial suggested ceftriaxone was more effective than penicillin in the treatment of neuroborreliosis.[8] Small observational studies suggest ceftriaxone is also effective in children.[9] The recommended duration of treatment is 14 to 28 days.[10][11]
Several studies from Europe have suggested oral doxycycline is equally as effective as intravenous ceftriaxone in treating neuroborreliosis. Doxycycline has not been widely studied as a treatment in the US, but antibiotic sensitivities of prevailing European and US isolates of Borrelia burgdorferi tend to be identical. However, doxycycline is generally not prescribed to children due to the risk of bone and tooth damage.[7]
Discredited treatments for neuroborreliosis include:
^Meyerhoff JO, Zaidman GW and Steele RW for Medscape Drugs & Diseases, Eds. Diamond HS et al. Lyme Disease Differential Diagnoses: Diagnostic Considerations Updated: Mar 14, 2016
^CDC Two-step Laboratory Testing Process Page last reviewed: March 4, 2015. Page last updated: March 26, 2015
^ abHalperin, John J. (June 2008). "Nervous System Lyme Disease". Infectious Disease Clinics of North America. 22 (2): 261–74, vi. doi:10.1016/j.idc.2007.12.009. PMID 18452800. S2CID 10590435.
^Dattwyler RJ, Halperin JJ, Volkman DJ, Luft BJ (May 1988). "Treatment of late Lyme borreliosis—randomised comparison of ceftriaxone and penicillin". Lancet. 1 (8596): 1191–4. doi:10.1016/s0140-6736(88)92011-9. PMID 2897008. S2CID 33352690.{{cite journal}}: CS1 maint: uses authors parameter (link)
^Bloom, Bradley J.; Wyckoff, Patricia M.; Meissner, H. Cody; Steere, Allen C. (March 1998). "Neurocognitive abnormalities in children after classic manifestations of Lyme disease". The Pediatric Infectious Disease Journal. 17 (3): 189–96. doi:10.1097/00006454-199803000-00004. PMID 9535244.
^Wormser, G. P.; Dattwyler, R. J.; Shapiro, E. D.; Halperin, J. J.; Steere, A. C.; Klempner, M. S.; Krause, P. J.; Bakken, J. S.; Strle, F.; Stanek, G.; Bockenstedt, L.; Fish, D.; Dumler, J. S.; Nadelman, R. B. (November 2006). "The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases. 43 (9): 1089–134. doi:10.1086/508667. PMID 17029130.
^Halperin, J. J.; Shapiro, E. D.; Logigian, E.; Belman, A. L.; Dotevall, L.; Wormser, G. P.; Krupp, L.; Gronseth, G.; Bever, C. T. (July 2007). "Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 69 (1): 91–102. doi:10.1212/01.wnl.0000265517.66976.28. PMID 17522387.
External links
February 26, 2023
neuroborreliosis, disorder, central, nervous, system, neurological, manifestation, lyme, disease, neuroborreliosis, caused, systemic, infection, spirochetes, genus, borrelia, symptoms, disease, include, erythema, migrans, like, symptoms, other, nameslyme, neur. Neuroborreliosis is a disorder of the central nervous system A neurological manifestation of Lyme disease neuroborreliosis is caused by a systemic infection of spirochetes of the genus Borrelia 1 Symptoms of the disease include erythema migrans and flu like symptoms 2 NeuroborreliosisOther namesLyme neuroborreliosis LNB SpecialtyInfectious diseases Contents 1 Signs and symptoms 2 Diagnosis 2 1 Differential diagnosis 3 Treatment 4 See also 5 References 6 External linksSigns and symptoms EditNeuroborreliosis is often preceded by the typical symptoms of Lyme disease which include erythema migrans and flu like symptoms such as fever and muscle aches Neurologic symptoms of neuroborreliosis include the meningoradiculitis which is more common in European patients cranial nerve abnormalities and altered mental status Sensory findings may also be present Rarely a progressive form of encephalomyelitis may occur In children symptoms of neuroborreliosis include headache sleep disturbance and symptoms associated with increased intracranial pressure such as papilledema Less common childhood symptoms can include meningitis myelitis ataxia and chorea Ocular Lyme disease has also been reported as has neuroborreliosis affecting the spinal cord but neither of these findings are common 3 Diagnosis EditDifferential diagnosis Edit A number of diseases can produce symptoms similar to those of Lyme neuroborreliosis They include Acute disseminated encephalomyelitis Viral meningitis Multiple sclerosis Bell s palsy 4 Diagnosis is determined by clinical examination of visible symptoms 5 Neuroborreliosis can also be diagnosed serologically to confirm clinical examination via western blot ELISA and PCR 6 Treatment EditIn the US neuroborreliosis is typically treated with intravenous antibiotics which cross the blood brain barrier such as penicillins ceftriaxone or cefotaxime 7 One relatively small randomized controlled trial suggested ceftriaxone was more effective than penicillin in the treatment of neuroborreliosis 8 Small observational studies suggest ceftriaxone is also effective in children 9 The recommended duration of treatment is 14 to 28 days 10 11 Several studies from Europe have suggested oral doxycycline is equally as effective as intravenous ceftriaxone in treating neuroborreliosis Doxycycline has not been widely studied as a treatment in the US but antibiotic sensitivities of prevailing European and US isolates of Borrelia burgdorferi tend to be identical However doxycycline is generally not prescribed to children due to the risk of bone and tooth damage 7 Discredited treatments for neuroborreliosis include Malariotherapy Hyperbaric oxygen therapy Colloidal silver Injections of hydrogen peroxide and bismacineSee also EditTick borne diseaseReferences Edit Rupprecht Tobias A Koedel Uwe Fingerle Volker Pfister Hans Walter 2008 The Pathogenesis of Lyme Neuroborreliosis From Infection to Inflammation Molecular Medicine 14 3 4 205 12 doi 10 2119 2007 00091 Rupprecht PMC 2148032 PMID 18097481 Koedel Uwe Fingerle Volker Pfister Hans Walter 2015 08 01 Lyme neuroborreliosis epidemiology diagnosis and management Nature Reviews Neurology 11 8 446 456 doi 10 1038 nrneurol 2015 121 ISSN 1759 4766 PMID 26215621 S2CID 13694627 Hildenbrand P Craven D E Jones R Nemeskal P 2009 Lyme Neuroborreliosis Manifestations of a Rapidly Emerging Zoonosis American Journal of Neuroradiology 30 6 1079 87 doi 10 3174 ajnr A1579 PMC 7051319 PMID 19346313 Lyme Disease at eMedicine Meyerhoff JO Zaidman GW and Steele RW for Medscape Drugs amp Diseases Eds Diamond HS et al Lyme Disease Differential Diagnoses Diagnostic Considerations Updated Mar 14 2016 CDC Two step Laboratory Testing Process Page last reviewed March 4 2015 Page last updated March 26 2015 a b Halperin John J June 2008 Nervous System Lyme Disease Infectious Disease Clinics of North America 22 2 261 74 vi doi 10 1016 j idc 2007 12 009 PMID 18452800 S2CID 10590435 Dattwyler RJ Halperin JJ Volkman DJ Luft BJ May 1988 Treatment of late Lyme borreliosis randomised comparison of ceftriaxone and penicillin Lancet 1 8596 1191 4 doi 10 1016 s0140 6736 88 92011 9 PMID 2897008 S2CID 33352690 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint uses authors parameter link Bloom Bradley J Wyckoff Patricia M Meissner H Cody Steere Allen C March 1998 Neurocognitive abnormalities in children after classic manifestations of Lyme disease The Pediatric Infectious Disease Journal 17 3 189 96 doi 10 1097 00006454 199803000 00004 PMID 9535244 Wormser G P Dattwyler R J Shapiro E D Halperin J J Steere A C Klempner M S Krause P J Bakken J S Strle F Stanek G Bockenstedt L Fish D Dumler J S Nadelman R B November 2006 The Clinical Assessment Treatment and Prevention of Lyme Disease Human Granulocytic Anaplasmosis and Babesiosis Clinical Practice Guidelines by the Infectious Diseases Society of America Clinical Infectious Diseases 43 9 1089 134 doi 10 1086 508667 PMID 17029130 Halperin J J Shapiro E D Logigian E Belman A L Dotevall L Wormser G P Krupp L Gronseth G Bever C T July 2007 Practice Parameter Treatment of nervous system Lyme disease an evidence based review Report of the Quality Standards Subcommittee of the American Academy of Neurology Neurology 69 1 91 102 doi 10 1212 01 wnl 0000265517 66976 28 PMID 17522387 External links Edit Retrieved from https en wikipedia org w index php title Neuroborreliosis amp oldid 1105686173, wikipedia, wiki, book, books, library,
