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[Lyme disease disclosed by disabling amyotrophy]

M Kianzowa1, O Saraceni, J M Wilhelm

  • 1Service de médecine, centre hospitalier Saint-Morand, Altkirch, France.

La Revue De Medecine Interne
|January 1, 1993
PubMed
Summary

Lyme disease can cause severe muscle weakness (amyotrophy) and pain. Diagnosis requires cerebrospinal fluid analysis, confirming the effectiveness of antibiotic treatment for this rare manifestation.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Rheumatology

Background:

  • Lyme disease, caused by Borrelia Burgdorferi, is a multisystemic infectious disorder first identified in 1975.
  • While various manifestations exist, muscle involvement is less commonly reported.

Observation:

  • A patient presented with severe amyotrophy in scapular, neck, and trunk muscles, scapula alata, and nocturnal lumbago resistant to NSAIDs.
  • Electromyography revealed myogenic patterns in specific muscles and neurogenic patterns in lower extremities.
  • Muscle biopsy, creatine kinase, aldolase, and serological tests were inconclusive.

Findings:

  • Diagnosis was confirmed via lymphocytic meningitis detected by lumbar puncture, with specific antibodies found in cerebrospinal fluid and Western Blot analysis.
  • Antibiotic therapy led to rapid symptom regression, validating the diagnosis.

Implications:

  • This case highlights the importance of considering Lyme disease in patients with unexplained amyotrophy and neurological symptoms.
  • Cerebrospinal fluid analysis is crucial for diagnosing atypical Lyme disease presentations.
  • Early antibiotic treatment is effective in resolving neurological and muscular manifestations of Lyme disease.

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