Acute LNB with CNS Involvement (Taiwan)

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
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RitaA
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Joined: Thu 1 Jul 2010 8:33

Acute LNB with CNS Involvement (Taiwan)

Post by RitaA » Fri 10 Aug 2012 19:09

http://www.ncbi.nlm.nih.gov/pubmed/20561635
J Neurol Sci. 2010 Aug 15;295(1-2):10-5. Epub 2010 Jun 18.

Acute neuroborreliosis with involvement of the central nervous system.

Chang BL, Shih CM, Ro LS, Huang CC, Lyu RK, Chen RS, Lee JD, Chao LL, Kuo HC.
Source
Department of Neurology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 199, Tung Hwa North Road, Taipei, Taiwan.

Abstract
BACKGROUND:
Lyme neuroborreliosis has not been previously reported in Taiwan. The purpose of this study was to describe the important characteristics of Lyme neuroborreliosis caused by Borrelia burgdorferi-like species in Taiwanese patients.

METHODS:
Patients with acute neurological symptoms without a clear explanation during September 2005 to December 2008 were enrolled. All patients received extensive auxiliary investigations, including clinical evaluation by neurological examination, electrophysiological and neuroimaging studies, serological screening tests of serum and cerebrospinal fluid (CSF) by indirect immunofluorescent assay, and Western immunoblot analysis conducted for seroreactivities in serum and CSF of Borrelia burgdorferi-specific IgM and IgG antibodies.

RESULTS:
Eleven patients who presented with acute central nervous system (CNS) syndrome fulfilled the diagnostic criteria for neuroborreliosis. In the CSF studies, lymphocytic pleocytosis with elevation of total protein and normal glucose was noted in 9 patients. The clinical syndromes were confirmed by magnetic resonance imaging and electrophysiological studies. Ten of 11 patients were found to have brain stem or spinal cord lesions on neuroimaging studies, and 8 patients had concomitant peripheral nervous system involvement with electrophysiological evidence of multiple root lesions with an acute or subacute course.

CONCLUSIONS:
Lyme neuroborreliosis presenting as acute CNS syndrome with peripheral nervous system involvement simultaneously in the disease course, especially acute myelopolyradiculitis, in Taiwan is different from Lyme neuroborreliosis seen in Europe and North America. The treatment outcome is variable and based on the severity of initial neurological deficits, early diagnosis, and early management.

Copyright (c) 2010 Elsevier B.V. All rights reserved.

Comment in
Do we need to broaden the spectrum of Lyme neuroborreliosis? [J Neurol Sci. 2010]
Would anyone here happen to have access to the comments made by Dr. Pachner? This is all I could find -- i.e. not even an abstract:

http://www.ncbi.nlm.nih.gov/pubmed/20621799
J Neurol Sci. 2010 Aug 15;295(1-2):8-9. Epub 2010 Jun 8.

Do we need to broaden the spectrum of Lyme neuroborreliosis?

Pachner AR.
Comment on
Acute neuroborreliosis with involvement of the central nervous system. [J Neurol Sci. 2010] Acute neuroborreliosis with involvement of the central nervous system.Chang BL, Shih CM, Ro LS, Huang CC, Lyu RK, Chen RS, Lee JD, Chao LL, Kuo HC. J Neurol Sci. 2010 Aug 15; 295(1-2):10-5. Epub 2010 Jun 18.
PMID:
20621799
[PubMed - indexed for MEDLINE]

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