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Successful treatment of Lyme encephalopathy with intravenous ceftriaxone

E L Logigian1, R F Kaplan, A C Steere

  • 1Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA. elogigian@mail.neurology.rochester.edu

The Journal of Infectious Diseases
|July 9, 1999
PubMed

Insights

Intravenous ceftriaxone effectively treated Lyme encephalopathy in 18 patients, improving cognitive function and neurological symptoms. Patients experienced significant recovery in memory, cerebrospinal fluid (CSF) abnormalities, and brain perfusion after a 30-day treatment course.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pharmacology

Background:

  • Lyme encephalopathy is a neurological complication of Lyme disease.
  • Patients often present with cognitive and mood disturbances.
  • Diagnostic challenges include memory deficits, CSF abnormalities, and perfusion defects.

Purpose of the Study:

  • To evaluate the efficacy of intravenous ceftriaxone in treating Lyme encephalopathy.
  • To assess treatment outcomes in patients with confirmed Lyme encephalopathy.

Main Methods:

  • A case series of 18 patients with strict Lyme encephalopathy criteria.
  • Treatment involved intravenous ceftriaxone (2 g/day for 30 days).
  • Evaluations included cognitive testing, cerebrospinal fluid (CSF) analysis, and SPECT imaging.

Main Results:

  • Significant improvement in memory scores (P<.01) after 6 months.
  • Reduced CSF protein levels (P<.05) in 10 patients.
  • Improved frontotemporal perfusion on SPECT imaging (P<.01) in 7 patients.
  • All 18 patients reported normal or improved status 12-24 months post-treatment.

Conclusions:

  • Intravenous ceftriaxone is a successful treatment for Lyme encephalopathy.
  • Treatment leads to sustained neurological and cognitive recovery.
  • Ceftriaxone offers a viable therapeutic option for this condition.

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