1/41. borrelia burgdorferi central nervous system infection presenting as an organic schizophrenialike disorder.BACKGROUND: We report on a 42-year-old female patient who presented with a schizophreniform disorder and complete relief of symptoms after specific therapy. methods: cerebrospinal fluid and magnetic resonance imaging findings led to the diagnosis of lyme disease. RESULTS: To our knowledge this is the first reported case with an exclusive psychiatric manifestation of lyme disease. CONCLUSIONS: In case of first manifestation of psychotic disorder, although neurological symptoms are lacking, lyme disease should be considered and be excluded by cerebrospinal fluid analysis.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
2/41. central nervous system infection caused by borrelia burgdorferi. Clinico-pathological correlation of three post-mortem cases.The spirochete borrelia burgdorferi (B. burgdorferi) may cause severe meningoencephalomyelitis as the sole manifestation of Lyme borreliosis. We would like to present three such cases, where definite neuroborreliosis was clinically diagnosed in two cases and possible neuroborreliosis was recognized in one case. Alive spirochetes were isolated and cultured from blood and cerebrospinal fluid (CSF) in both definite cases. B. burgdorferi as the causative agent of the infection was confirmed in CSF by polymerase chain reaction (PCR) in one definite case. In the possible case spirochetes were cultured from blood and CSF. Alive spirochetes were not isolated, however anti-B. burgdorferi antibody value in serum was significantly elevated. On necropsy gross examination brain edema without focal changes was detected in two cases. Cerebral atrophy was seen in Case 3. Microscopically, lymphocytic infiltrates, microglial diffuse and nodular activation, spongiform changes, diffuse demyelination of the cerebral and cerebellar white matter, and diffuse astrocytosis, were characteristic pathological features in all presented cases. Multifocal, perivascular degenerative changes in the cerebral and cerebellar white matter were observed in the first case. Inflammatory changes in the nuclei and roots of cranial nerves were present in the third case.- - - - - - - - - - ranking = 0.44566094863792keywords = nervous system, brain (Clic here for more details about this article) |
3/41. Isolated neuritis of the sciatic nerve in a case of lyme disease.lyme disease is an infectious disease caused by the spirochete borrelia burgdorferi. The course of the disease is divided into three stages, the second of which may include various types of peripheral nervous system disturbances. We report the case of a patient with persistent deficits caused by the prevalent involvement of the sciatic nerve, confirmed by electrophysiological and neuropathological findings. The most significant bioptic results were axonal degeneration and perivascular inflammation. Damage to a single peripheral nerve as the dominant clinical expression during the course of lyme disease is an unusual finding that has been rarely described in the literature.- - - - - - - - - - ranking = 0.1106291371415keywords = nervous system (Clic here for more details about this article) |
4/41. Case and discussion of lyme disease.lyme disease is a multisystem disease with prominent neurological involvement, primarily affecting the nervous system, skin, joints, and heart. We report the case of a patent with lyme disease and discuss the background as treatment of this condition.- - - - - - - - - - ranking = 0.1106291371415keywords = nervous system (Clic here for more details about this article) |
5/41. Lyme-associated parkinsonism: a neuropathologic case study and review of the literature.Neurological complications of lyme disease include meningitis, encephalitis, dementia, and, rarely, parkinsonism. We present a case of striatonigral degeneration, a form of multiple system atrophy, in Lyme-associated parkinsonism. A 63-year-old man presented with erythema migrans rash, joint pains, and tremors. serum and cerebrospinal fluid antibodies and polymerase chain reaction for borrelia burgdorferi were positive. Clinical parkinsonism was diagnosed by several neurologists. Despite treatment, the patient continued to decline, with progressive disability, cognitive dysfunction, rigidity, and pulmonary failure. At autopsy, the brain showed mild basal ganglia atrophy and substantia nigra depigmentation, with extensive striatal and substantia nigral neuronal loss and astrogliosis. No lewy bodies were identified; however, ubiquitin-positive glial cytoplasmic inclusions were identified in striatal and nigral oligodendroglia. There were no perivascular or meningeal infiltrates, the classic findings of neuroborreliosis. To our knowledge, this is the first report of striatonigral degeneration in a patient with B burgdorferi infection of the central nervous system and clinical Lyme-associated parkinsonism.- - - - - - - - - - ranking = 0.25314440007192keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
6/41. Lyme carditis: restitutio ad integrum documented by cardiac magnetic resonance imaging.lyme disease is a tickborne illness that could cause, weeks to months later, complications involving the joints, central nervous system, and cardiovascular system. We report a case of cardiac manifestation with transitory higher degree atrioventricular block and dysfunction of the left ventricle. Complete resolution without signs of myocardial scar is demonstrated by cardiac magnetic resonance imaging.- - - - - - - - - - ranking = 0.25keywords = central nervous system, nervous system (Clic here for more details about this article) |
7/41. lyme neuroborreliosis manifesting as an intracranial mass lesion.lyme neuroborreliosis is one of the chronic manifestations of lyme disease and is caused by the neurotropic spirochete, borrelia burgdorferi. Two of the three stages of lyme disease potentially involve the central nervous system: a second stage that may manifest as meningitis, cranial neuritis, or radiculoneuritis; and a third stage, or chronic neuroborreliosis, with parenchymal involvement. The tertiary stage may mimic many conditions, including multiple sclerosis, polyneuropathy, viral encephalitis, brain tumor, vasculitis, encephalopathy, psychiatric illness, and myelopathy. We report a 10-year-old child with signs, symptoms, and radiological manifestations of intracranial mass lesions, without previously recognized manifestations of lyme disease. This proved to be lyme neuroborreliosis, documented by histological and serological examination, which responded well to antibiotic therapy. The need to establish a tissue diagnosis of intracranial mass lesions is emphasized, and the utility of a computed tomographic-guided stereotactic system for this purpose is discussed.- - - - - - - - - - ranking = 0.25314440007192keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
8/41. The clinical and epidemiological profile of lyme neuroborreliosis in denmark 1985-1990. A prospective study of 187 patients with borrelia burgdorferi specific intrathecal antibody production.This prospective study reports the clinical and epidemiological features of 187 consecutive patients with neuroborreliosis recognized in denmark over the 6-yr period, 1985-1990. Only patients with intrathecal borrelia burgdorferi specific antibody synthesis were included. In 1990 regional incidences varied between 5.7 and 24.1 per million. Ninety-four percent of the patients had early (second stage) neuroborreliosis. The most common manifestation was a painful lymphocytic meningoradiculitis (Bannwarth's syndrome) either with paresis (61%) or as a radicular pain syndrome only (25%). central nervous system (CNS) involvement in early neuroborreliosis was rare; 4% had signs of myelitis and only one patient had acute encephalitis. Children showed a different course of the disease. Six percent of the patients suffered a chronic course with a disease duration between 6 mths and 6 yrs either as chronic lymphocytic meningitis (1.6%) or as third stage chronic encephalomyelitis (4.3%). Meningeal signs were rare despite pronounced inflammatory cerebrospinal fluid (CSF) changes (median cell count 160/microliters; median protein concentration 1.13 g/l). High dose i.v. penicillin g was administered to 91% of the patients. Based on the clinical outcome and normalization of CSF no treatment failures were recognized. The final morbidity after a median follow-up of 33 mths was low; disabling sequelae were reported in nine patients, mainly those with previous CNS involvement. We conclude that neuroborreliosis is a common and characteristic neurological disorder. The diagnosis should be based on the demonstration of inflammatory CSF changes and B. burgdorferi specific intrathecal antibody production.- - - - - - - - - - ranking = 0.1106291371415keywords = nervous system (Clic here for more details about this article) |
9/41. lyme disease of the brainstem.lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, borrelia burgdorferi. central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement. We describe a patient who presented with clinical findings suggesting a brainstem process. magnetic resonance imaging (MRI) and positron emission tomography (PET) suggested a brainstem neoplasm. Prior to biopsy, laboratory evaluation led to the diagnosis of lyme disease. Clinical and imaging abnormalities improved markedly following antimicrobial therapy. We describe lyme disease involvement of the cerebellar peduncles with hypermetabolism on PET. Although MRI is the primary imaging modality for most suspected CNS pathology, the practical applications of PET continue to expand.- - - - - - - - - - ranking = 0.13263993764492keywords = nervous system, brain (Clic here for more details about this article) |
10/41. lyme disease associated with Alzheimer's disease.This case report discusses a patient with co-occurring neuroborreliosis and Alzheimer's disease (AD). Although no claim is made for causality nor is there objective evidence that spirochetes are involved in AD, co-infection may exacerbate the symptoms of either neuroborreliosis or AD. Much is to be learned about the role of spirochetes in degenerative central nervous system disease.- - - - - - - - - - ranking = 0.25keywords = central nervous system, nervous system (Clic here for more details about this article) |
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