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Peripheral neuropathy
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
x – Lyme disease. The characteristic ‘bullseye’ rash is known as erythema migrans and usually results from a tick bite that causes an infection with Borrelia burgdorferi. The infection can affect the CNS and/or the peripheral nervous system usually 1–4 weeks after the tick bite. This is known as neuroborreliosis and can result in meningitis, meningoradiculitis, cranial neuritis, encephalopathy, peripheral neuropathy and encephalitis. It can even cause neuropsychiatrie disorders including mania, psychosis and dementia.4
Encephalitis and Its Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Two spirochetal infections commonly involve the nervous system – neurosyphilis (Treponema pallidum) and neuroborreliosis. Neuroborreliosis, or nervous system Lyme disease, is typically caused by Borreliella (formerly Borrelia) burgdorferi in North America, by the closely related organisms B. afzelii, B. garinii, and others in Eurasia. Both commonly cause meningitis quite early in infection. In both, the basilar meningitis can be accompanied by cranial neuropathies. Both may develop parenchymal nervous system involvement later in infection, although this appears to be far more common in neurosyphilis.
Ceftriaxone
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Baek-Nam Kim, Anna Maria Peri, David L. Paterson
The recommended dose of ceftriaxone is 2 g administered i.v. daily for 14 days (range: 10–28 days) for early Lyme disease with acute neurological disease manifested by meningitis or radiculopathy, or patients with seventh cranial nerve palsy with CNS involvement; for 14–21 days for the initial treatment of hospitalized patients with Lyme carditis; for 14–28 days for Lyme arthritis with neurological involvement, including those refractory to oral therapy, or late neurologic Lyme disease (Wormser et al., 2006; Stanek et al., 2012; Shapiro, 2014). A review by the American Academy of Neurology determined ceftriaxone to be a safe and effective treatment for neuroborreliosis, including both peripheral and central nervous system manifestations (Halperin et al., 2007). A dose of ceftriaxone 50–70 mg/kg i.v. daily is recommended for children (Wormser et al., 2006; Stanek et al., 2012; Shapiro, 2014).
Lyme Neuroborreliosis Presenting as Multiple Cranial Neuropathies
Published in Neuro-Ophthalmology, 2022
Aishwarya Sriram, Samantha Lessen, Kevin Hsu, Cheng Zhang
With regard to neuroborreliosis, approximately 20% of patients with Lyme disease have some degree of neurological involvement, and this tends to occur in the second or third stages.1 The Borrelia bugdorferi spirochaete can produce symptomatic neurological disease or remain dormant in the central nervous system for long periods of time.4 Central nervous system involvement can present as meningitis, encephalitis, cranial neuritis, and radiculoneuropathy early on. Thereafter, encephalomyelitis and encephalopathy may occur. Lyme has also been associated with the development of psychiatric conditions, including bipolar, major depression, and schizophrenia, among others.5 Neuroborreliosis can be treated with oral or parenteral antibiotics, such as doxycycline, amoxycillin, or a cephalosporin.2
Alzheimer’s disease and gastrointestinal microbiota; impact of Helicobacter pylori infection involvement
Published in International Journal of Neuroscience, 2021
Michael Doulberis, Georgios Kotronis, Dimitra Gialamprinou, Stergios A. Polyzos, Apostolis Papaefthymiou, Panagiotis Katsinelos, Jannis Kountouras
An analysis of rectal samples collected during a prospective observational study [64] was conducted among residents of nursing home with advanced dementia and Clostridium difficile. The authors concluded that subjects with advanced dementia were characterized by a significant gut dysbiosis. Noteworthy is also a case report of a patient with co-occurring AD and neuroborreliosis [65]. The authors discussed a possible exacerbation of the symptoms of either neuroborreliosis or AD through this co-infection.
Acute neuroborreliosis presenting with severe hyponatremia: a case report
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Ismaïl Ould-Nana, Pierre-Yves Decleire, Sabina Boangher, Philippe Glorieux
This case report highlights the possibility of Lyme disease presenting with severe electrolyte disturbances from SIADH, as well as autonomic neuropathy. The history of a tick bite and erythema migrans and the results of serologic tests helped establish the diagnosis. Oral doxycycline treatment was very effective, producing complete resolution of neuroborreliosis.