[Neuro-borreliosis or intervertebral disk prolapse?]

Area of Science:

• Neurology
• Infectious Diseases
• Medical Research

Background:

• Neuro-borreliosis is a serious manifestation of Borrelia infection affecting the nervous system.
• Early diagnosis and treatment are crucial for managing this condition.
• Patient recall of tick bites or erythema migrans is often low.

Purpose of the Study:

• To analyze the clinical presentation, diagnostic challenges, and treatment outcomes of neuro-borreliosis.
• To investigate the recurrence rates and long-term sequelae of the infection.

Main Methods:

• Retrospective analysis of 17 patients hospitalized for neuro-borreliosis between 1986 and 1988.
• Review of patient records, including symptoms, diagnostic test results (IgG antibodies in serum and cerebrospinal fluid), and treatment regimens.
• Follow-up assessment for treatment response and recurrence.

Main Results:

• Ten patients presented with suspected root or compression syndromes; six had facial paresis.
• Antibody detection was inconsistent, with three patients negative for IgG in serum or CSF initially.
• Six patients experienced recurrence despite antibiotic therapy (penicillin, doxycycline, or ceftriaxone).
• Four patients developed residual painful polyneuropathy.

Conclusions:

• Neuro-borreliosis diagnosis can be challenging due to non-specific symptoms and variable serological findings.
• Recurrence is a significant concern, necessitating careful monitoring and potentially alternative treatment strategies.
• Persistent neurological deficits, such as painful polyneuropathy, can occur even after appropriate treatment.