Chronic Lyme neuroborreliosis
Introduction. Lyme neuroborreliosis is an infectious disorder of the central and/or peripheral nervous system caused by the tick stump of the genus Ixodes rici, infected with species Borrelia burgdorferi sensu lato (in Europe). The disease manifests as meningitis, encephalitis, meningoradiculitis, v...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society, Department of Emergency Medicine, Belgrade
2021-01-01
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| Series: | ABC: časopis urgentne medicine |
| Subjects: | |
| Online Access: | https://scindeks-clanci.ceon.rs/data/pdf/1451-1053/2021/1451-10532102024S.pdf |
| _version_ | 1797976705008140288 |
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| author | Srećković Biljana P. Knežević Snezana B. Đorđević Slavica S. |
| author_facet | Srećković Biljana P. Knežević Snezana B. Đorđević Slavica S. |
| author_sort | Srećković Biljana P. |
| collection | DOAJ |
| description | Introduction. Lyme neuroborreliosis is an infectious disorder of the central and/or peripheral nervous system caused by the tick stump of the genus Ixodes rici, infected with species Borrelia burgdorferi sensu lato (in Europe). The disease manifests as meningitis, encephalitis, meningoradiculitis, vasculitis, paresthesia of the facial nerve and painful radiculopathy. Case report. A 44-year-old patient reports fatigue, forgetfulness, headache, confusion, depression, drowsiness, irritability, instability, her undercooks are crushed, sheeps of a bride and does not recall being called an object. Muscular reflexes of the undergrowth are reduced. Plantar response flexion, Lazarevic sign is positive at 45 degrees from the surface. No weakness of the dorsal and plantar flexion of the fingers of the feet. Relieves sensitivity in the region of inertia nerv peroneus and tibialis. Sphincters were fine. The patient had a diagnosed Lyme disease, five months prior to the exacerbation of anxiety. Due to erythema migrans and subfebrility, diagnosis and seropositivity to Borrelia burgdorferi were established in both classes of the enzymelinked immunosorbent assay antibodies and a confirmed Western blot test. She took doxycycline 200 milligrams/day, three weeks. The analysis of cerebrospinal fluid revealed proteinhorn (0.42 g/L), normal glycorrhachia, pleocytosis, and positive intrathecal IgG antibodies. Electromyography pointed to axonal degeneration of the lower extremities. The magnetic resonance is neat. The therapy includes ceftriaxone, 2 grams/day, vitamins and analgesic therapy. Neuroborreliois was maintained by the laboratory during one-year follow-up. Mental disorders, headaches, confusion and irritability, neurological signs have significantly regressed. Conclusion. The gold standard in diagnostics of neuroborelliosis is the determination of intrathecal antibodies. For the definitive diagnosis, clinical signs of disease, pleocytosis and positive antibodies are necessary. Intrathecal antibodies remain long positive and they are not recommended for monitoring for the effects of therapy. |
| first_indexed | 2024-04-11T04:55:11Z |
| format | Article |
| id | doaj.art-2312c1ba87c04176a1152403fb17c9a7 |
| institution | Directory Open Access Journal |
| issn | 1451-1053 2560-3922 |
| language | English |
| last_indexed | 2024-04-11T04:55:11Z |
| publishDate | 2021-01-01 |
| publisher | Serbian Medical Society, Department of Emergency Medicine, Belgrade |
| record_format | Article |
| series | ABC: časopis urgentne medicine |
| spelling | doaj.art-2312c1ba87c04176a1152403fb17c9a72022-12-26T14:47:04ZengSerbian Medical Society, Department of Emergency Medicine, BelgradeABC: časopis urgentne medicine1451-10532560-39222021-01-01212243110.5937/abc2102024S1451-10532102024SChronic Lyme neuroborreliosisSrećković Biljana P.0Knežević Snezana B.1https://orcid.org/0000-0001-9137-2122Đorđević Slavica S.2Dom zdravlja Kraljevo, Kraljevo, SerbiaDom zdravlja Kraljevo, Kraljevo, SerbiaAkademija strukovnih studija, Odsek Visoka zdravstvena škola, Beograd, SerbiaIntroduction. Lyme neuroborreliosis is an infectious disorder of the central and/or peripheral nervous system caused by the tick stump of the genus Ixodes rici, infected with species Borrelia burgdorferi sensu lato (in Europe). The disease manifests as meningitis, encephalitis, meningoradiculitis, vasculitis, paresthesia of the facial nerve and painful radiculopathy. Case report. A 44-year-old patient reports fatigue, forgetfulness, headache, confusion, depression, drowsiness, irritability, instability, her undercooks are crushed, sheeps of a bride and does not recall being called an object. Muscular reflexes of the undergrowth are reduced. Plantar response flexion, Lazarevic sign is positive at 45 degrees from the surface. No weakness of the dorsal and plantar flexion of the fingers of the feet. Relieves sensitivity in the region of inertia nerv peroneus and tibialis. Sphincters were fine. The patient had a diagnosed Lyme disease, five months prior to the exacerbation of anxiety. Due to erythema migrans and subfebrility, diagnosis and seropositivity to Borrelia burgdorferi were established in both classes of the enzymelinked immunosorbent assay antibodies and a confirmed Western blot test. She took doxycycline 200 milligrams/day, three weeks. The analysis of cerebrospinal fluid revealed proteinhorn (0.42 g/L), normal glycorrhachia, pleocytosis, and positive intrathecal IgG antibodies. Electromyography pointed to axonal degeneration of the lower extremities. The magnetic resonance is neat. The therapy includes ceftriaxone, 2 grams/day, vitamins and analgesic therapy. Neuroborreliois was maintained by the laboratory during one-year follow-up. Mental disorders, headaches, confusion and irritability, neurological signs have significantly regressed. Conclusion. The gold standard in diagnostics of neuroborelliosis is the determination of intrathecal antibodies. For the definitive diagnosis, clinical signs of disease, pleocytosis and positive antibodies are necessary. Intrathecal antibodies remain long positive and they are not recommended for monitoring for the effects of therapy.https://scindeks-clanci.ceon.rs/data/pdf/1451-1053/2021/1451-10532102024S.pdflyme neuroborreliosisheadacheneuropathyparesthesiaantibiotics |
| spellingShingle | Srećković Biljana P. Knežević Snezana B. Đorđević Slavica S. Chronic Lyme neuroborreliosis ABC: časopis urgentne medicine lyme neuroborreliosis headache neuropathy paresthesia antibiotics |
| title | Chronic Lyme neuroborreliosis |
| title_full | Chronic Lyme neuroborreliosis |
| title_fullStr | Chronic Lyme neuroborreliosis |
| title_full_unstemmed | Chronic Lyme neuroborreliosis |
| title_short | Chronic Lyme neuroborreliosis |
| title_sort | chronic lyme neuroborreliosis |
| topic | lyme neuroborreliosis headache neuropathy paresthesia antibiotics |
| url | https://scindeks-clanci.ceon.rs/data/pdf/1451-1053/2021/1451-10532102024S.pdf |
| work_keys_str_mv | AT sreckovicbiljanap chroniclymeneuroborreliosis AT knezevicsnezanab chroniclymeneuroborreliosis AT đorđevicslavicas chroniclymeneuroborreliosis |