Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome

Tick-borne encephalitis (TBE) and Lyme neuroborreliosis (LNB), the most common tick-borne diseases of the central nervous system in Central Europe, are frequently associated with pareses. The aim of this study was to characterise paretic complications in patients with TBE and LNB, including their se...

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Main Authors: Dita Smíšková, Dušan Pícha, Martin Slížek, Olga Džupová
Format: Article
Language:English
Published: Elsevier 2024-03-01
Series:Ticks and Tick-Borne Diseases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1877959X23001838
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author Dita Smíšková
Dušan Pícha
Martin Slížek
Olga Džupová
author_facet Dita Smíšková
Dušan Pícha
Martin Slížek
Olga Džupová
author_sort Dita Smíšková
collection DOAJ
description Tick-borne encephalitis (TBE) and Lyme neuroborreliosis (LNB), the most common tick-borne diseases of the central nervous system in Central Europe, are frequently associated with pareses. The aim of this study was to characterise paretic complications in patients with TBE and LNB, including their severity, persistence and impact on the patients' quality of life. Our retrospective observational study included patients with aseptic CNS infection due to TBE virus or Borrelia burgdorferi sensu lato. Paretic complications were evaluated in the acute phase and the patients were followed up until complete regression or long-term stabilisation of any neurological deficit. The severity of the neurological deficit was graded according to the modified Rankin Scale (mRS).A total of 823 patients (582 with TBE, 241 with LNB) was included. Paretic complications were diagnosed in 63 TBE patients (10.8 %) and in 147 LNB patients (61.0 %). In TBE, the most common neurological deficit was brachial plexus paresis in 21 patients (33 %) and bulbar symptoms in 18 patients (29 %). In LNB patients, facial nerve palsy was the most frequent neurological deficit (117patients; 79.6 %), followed by lower limb paresis in 23 patients (15.6 %). Forty-nine TBE patients and 134 LNB paretic patients completed follow-up. Paresis resolved within 3 weeks in 16 TBE patients (33 %) and 53 LNB patients (39.5 %), but the proportion of patients with paresis persisting for more than 12 months was significantly higher in TBE (34.7 vs. 3.7 %, p < 0.001). The mean mRS was significantly higher in TBE paretic patients compared to LNB (p < 0.001).Paretic complications are significantly more common in LNB than in TBE but pareses associated with TBE last longer than in LNB and considerably reduce the quality of life of patients. Prevention remains the only way to influence the long-term motor deficits of TBE.
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spelling doaj.art-f5af98a4d95147e3bfc0fabea8001a052024-02-08T05:07:28ZengElsevierTicks and Tick-Borne Diseases1877-96032024-03-01152102302Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcomeDita Smíšková0Dušan Pícha1Martin Slížek2Olga Džupová3Second Faculty of Medicine, Charles University, University Hospital Bulovka, Budínova 2, Prague 180 81, Czech Republic; Corresponding author.Second Faculty of Medicine, Charles University, University Hospital Bulovka, Budínova 2, Prague 180 81, Czech RepublicSecond Faculty of Medicine, Charles University, University Hospital Bulovka, Budínova 2, Prague 180 81, Czech RepublicThird Faculty of Medicine, Charles University, University Hospital Bulovka, Budínova 2, Prague 180 81, Czech RepublicTick-borne encephalitis (TBE) and Lyme neuroborreliosis (LNB), the most common tick-borne diseases of the central nervous system in Central Europe, are frequently associated with pareses. The aim of this study was to characterise paretic complications in patients with TBE and LNB, including their severity, persistence and impact on the patients' quality of life. Our retrospective observational study included patients with aseptic CNS infection due to TBE virus or Borrelia burgdorferi sensu lato. Paretic complications were evaluated in the acute phase and the patients were followed up until complete regression or long-term stabilisation of any neurological deficit. The severity of the neurological deficit was graded according to the modified Rankin Scale (mRS).A total of 823 patients (582 with TBE, 241 with LNB) was included. Paretic complications were diagnosed in 63 TBE patients (10.8 %) and in 147 LNB patients (61.0 %). In TBE, the most common neurological deficit was brachial plexus paresis in 21 patients (33 %) and bulbar symptoms in 18 patients (29 %). In LNB patients, facial nerve palsy was the most frequent neurological deficit (117patients; 79.6 %), followed by lower limb paresis in 23 patients (15.6 %). Forty-nine TBE patients and 134 LNB paretic patients completed follow-up. Paresis resolved within 3 weeks in 16 TBE patients (33 %) and 53 LNB patients (39.5 %), but the proportion of patients with paresis persisting for more than 12 months was significantly higher in TBE (34.7 vs. 3.7 %, p < 0.001). The mean mRS was significantly higher in TBE paretic patients compared to LNB (p < 0.001).Paretic complications are significantly more common in LNB than in TBE but pareses associated with TBE last longer than in LNB and considerably reduce the quality of life of patients. Prevention remains the only way to influence the long-term motor deficits of TBE.http://www.sciencedirect.com/science/article/pii/S1877959X23001838Lyme neuroborreliosisTick-borne encephalitisParesisLong-term deficit
spellingShingle Dita Smíšková
Dušan Pícha
Martin Slížek
Olga Džupová
Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome
Ticks and Tick-Borne Diseases
Lyme neuroborreliosis
Tick-borne encephalitis
Paresis
Long-term deficit
title Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome
title_full Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome
title_fullStr Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome
title_full_unstemmed Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome
title_short Paretic complications of tick-borne encephalitis and Lyme neuroborreliosis in the Czech Republic: Characteristics and clinical outcome
title_sort paretic complications of tick borne encephalitis and lyme neuroborreliosis in the czech republic characteristics and clinical outcome
topic Lyme neuroborreliosis
Tick-borne encephalitis
Paresis
Long-term deficit
url http://www.sciencedirect.com/science/article/pii/S1877959X23001838
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