Abstract
Lyme neuroborreliosis (involvement of the central and/or peripheral nervous system due to infection withB. burgdorferisensu lato) is the second most frequent manifestation of Lyme borreliosis in Europe, while it comprises the third most common expression of the disease in North America. Early Lyme neuroborreliosis, which is much better defined and far more common than late Lyme neuroborreliosis, is in Europe caused mainly byB. gariniiand comprises the classic triad of meningitis, radiculoneuritis and/or cranial neuropathy, while in American patients subacute meningitis with or without cranial neuropathy is the most common manifestation. Among chronic forms of European Lyme neuroborreliosis peripheral neuritis associated with acrodermatitis chronic atrophicans is most frequently observed. A reliable diagnosis of borrelial central nervous system infection requires demonstration of lymphocytic pleocytosis and the evidence of borrelial infection of the central nervous system, established by intrathecal synthesis of specific antibodies and/or isolation ofBorreliaefrom the cerebrospinal fluid. Treatment with oral doxycycline, or parenteral penicillin or third generation cephalosporins (most frequently ceftriaxone) for 2-4 weeks is efficient in the majority of patients..
Highlights
Lyme borreliosis is a multi-systemic infectious disease caused by the spirochete Borrelia burgdorferi sensu lato
Ogrinc and Maraspin majority of patients peripheral facial palsy of borrelial origin is associated with lymphocytic pleocytosis, indicating concomitant central nervous system (CNS) involvement, symptoms and signs of meningitis are frequently absent [1, 6, 45, 46]
That the above described typical clinical manifestations of early Lyme neuroborreliosis in European patients are due to B. garinii infection
Summary
Lyme borreliosis is a multi-systemic infectious disease caused by the spirochete Borrelia burgdorferi sensu lato (B.burgdorferi s.l.), and is transmitted by Ixodes species ticks [1]. It is defined as a painful meningo-radiculoneuritis with or without peripheral or cranial nerve affection, caused by infection with B. burgdorferi s.l. In a substantial number of patients (34-64%) EM may appear prior to or concomitant with neurological impairment [29, 26 - 36] Neurological symptoms typically develop 4-6 weeks after a tick bite or appearance of EM.
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