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Involvement of Borrelia burgdorferi in cranial nerve affection
Abstract:
From January 1984 to August 1985 54 patients presented with cranial nerve lesions at the neurological department of the University hospital Innsbruck. Median age was 42 years, range 5-81 years. Female male ratio was 49/15. In 17 patients cranial neuritis was consistent with meningopolyneuritis Bannwarth (MPN) in 37 cases mere facial palsy was present. Cranial neuritis in MPN-patients affected N. facilis in 10, N. opticus and N. oculo-motorius in one case each. Five patients had polyneuritis cranialis with affection of the cranial nerves II, V, VI, VII, VIII, and IX (Table 1). IgG-antibodies to B. burgdorferi were found in the sera of all MPN patients and in 15 of cases with mere facial palsy. Patients with antibodies to B. burgdorferi were treated with intravenous penicillin and latamoxef dinatrium. The remaining 22 patients were treated with vitamin B compound and corticosteroids. The time for full recovery was 4 weeks on the average in each treatment group.
Insights
Meningopolyneuritis Bannwarth (MPN) and facial palsy cases were linked to Borrelia burgdorferi antibodies. Prompt treatment with antibiotics or supportive care led to similar recovery times, suggesting effective management for these neurological conditions.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Cranial nerve lesions can present as isolated facial palsy or more complex syndromes like meningopolyneuritis Bannwarth (MPN).
- Borrelia burgdorferi infection is a known cause of neurological manifestations, including cranial nerve palsies.
Purpose of the Study:
- To investigate the prevalence of Borrelia burgdorferi antibodies in patients with cranial nerve lesions.
- To compare the treatment outcomes for patients with MPN and facial palsy based on serological findings.
Main Methods:
- Retrospective analysis of 54 patients with cranial nerve lesions presenting between January 1984 and August 1985.
- Serological testing for IgG antibodies to Borrelia burgdorferi.
- Comparison of treatment regimens: intravenous antibiotics (penicillin and latamoxef dinatrium) versus vitamin B complex and corticosteroids.
Main Results:
- All 17 patients diagnosed with MPN showed positive IgG antibodies to B. burgdorferi.
- Fifteen of 37 patients with isolated facial palsy also had antibodies to B. burgdorferi.
- Both antibiotic and supportive treatment groups demonstrated an average full recovery time of 4 weeks.
Conclusions:
- Borrelia burgdorferi infection is a significant factor in cranial nerve lesions, particularly MPN and facial palsy.
- Prompt treatment with either antibiotics or supportive care yields comparable recovery times for these conditions.
- Further research into the specific mechanisms and optimal treatment strategies for B. burgdorferi-associated neurological disorders is warranted.