TITLE: [Neuroborreliosis in a patient with progressive supranuclear
paralysis. An association or the cause?]
VERNACULAR TITLE: Neuroborreliosis en un paciente con paralisis
supranuclear progresiva: asociacion o causa?
AUTHORS: Garcia-Moreno JM;
Izquierdo G; Chacon J; Angulo S; Borobio MV
AUTHOR AFFILIATION: Departamento de Inmunologia, Hospital Universitario Virgen de la Macarena, Sevilla, Espana. Ay...@arrakis.es
SOURCE: Rev Neurol 1997 Dec;25(148):1919-21
CITATION IDS: PMID: 9528031 UI: 98188456
ABSTRACT:
INTRODUCTION: Many different neurological conditions may be seen in the
later stages of Lyme Disease, such as blindness, epileptic crises,
CVA, extrapyramidal disorders, amyotrophic lateral sclerosis, and
dementia may be yet another form of presentation of chronic infection
due to Borrelia burgdorferi (Bb). Progressive Supranuclear Paralysis
(PSP), a disorder of unknown aetiology, considered to be the commonest
cause of Parkinsonism-plus, one of the symptoms of which is dementia,
has never been mentioned in this type of differential diagnosis.
CLINICAL CASE: We present the case of a 78 year old man with sub-acute
mental deterioration, Bb positive serology in both plasma and CSF, and
with clinical and epidemiological features compatible with Lyme's
Disease. Complementary tests were negative. The syndrome corresponded
to Lyme's Disease and improved after treatment with ceftriaxona.
CONCLUSIONS: We consider aspects of the aetiology of PSP which are still not clear. In our patient, the aetiology seemed to be Bb infection, according to the criteria of the original description of the disease and in view of the neuropathological findings which have shown Bb in the substancia nigra of the mid-brain and the existence of an animal model in which Bb shows a particular tendency to colonize infratentorial structures.
MAIN MESH HEADINGS: Borrelia
burgdorferi/*isolation & purification
Lyme Disease/*complications
Substantia Nigra/*microbiology
Substantia Nigra/*pathology
Supranuclear Palsy, Progressive/*diagnosis
Supranuclear Palsy, Progressive/*microbiology
ADDITIONAL MESH HEADINGS: Aged
Antiparkinson Agents/therapeutic use
Case Report
Ceftriaxone/therapeutic use
Cephalosporins/therapeutic use
Dementia/etiology
Electroencephalography
English Abstract
Facies Frontal Lobe/radionuclide imaging Human Lyme Disease/drug
therapy Magnetic Resonance Imaging Male Parietal Lobe/radionuclide
imaging Supranuclear Palsy, Progressive/drug therapy Temporal
Lobe/radionuclide imaging Tomography, Emission-Computed, Single-Photon
1998/04 1998/07 02:02 PUBLICATION TYPES: JOURNAL ARTICLE CAS REGISTRY
NUMBERS: 0 (Antiparkinson Agents) 0 (Cephalosporins) 73384-59-5
(Ceftriaxone) LANGUAGES: Spa
Title: [Neurologic forms of Lyme disease. 12 cases]
Authors: Viader F, Poncelet AM, Chapon F, Thenint JP, Dupuy B, Morin P,
Lechevalier B
Source: Rev Neurol (Paris) 1989;145(5):362-8
Organization: Service de Neurologie Dejerine, CHU de Caen.
Abstract:
Twelve cases of Lyme disease with neurological complications are
reported. Seven patients had meningoradiculitis of the Garin-Bujadoux-
Bannwarth type, with facial palsy in 2 cases. In 1 case the radiculitis
involved only the cauda equina. Two more patients had meningomyelitis.
Of the remaining 3, 1 had subacute inflammatory polyneuritis with
albumino-cytologic dissociation, 1 had probable dorsal epiduritis, and
the last one developed parkinsonism and communicating hydrocephalus
after an otherwise classical meningoradiculitis. Three patients
recalled a tick bite but only one a cutaneous eruption. No arthritis or
cardiac involvement were observed. In 2 cases the CSF contained pseudo-
neoplastic cells. Severe pain was a prominent feature in most cases.
Pain consistently and rapidly improved on high-dose intravenous
penicillin, while other signs or symptoms (e.g. paresthesias or
fatigue) often lasted several months. Parkinsonism and hydrocephalus
were not influenced by penicillin, and both required specific therapy.
Isolated neurological (both central and peripheral) involvement is not
unusual in Lyme's disease and may give rise to a wide range of signs
and symptoms. This diagnosis is to be considered even when other
features of Borrelia burgdorferi infection are lacking.
Keywords:
Adult, Aged, English Abstract, Female, Follow-Up Studies, Human, Lyme
Disease, CEREBROSPINAL FLUID, COMPLICATIONS, DIAGNOSIS, Male, Middle
Age, Myelitis, CEREBROSPINAL FLUID, DRUG THERAPY, ETIOLOGY,
Penicillins, THERAPEUTIC USE, Radiculitis, CEREBROSPINAL FLUID, DRUG
THERAPY, ETIOLOGY, Serology
Language: Fre
Unique ID: 89297964
