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[Meningopapillitis disclosing Lyme disease]
Revue Neurologique
|June 1, 1996
Summary
A 65-year-old woman with neuroborreliosis experienced low back pain and vision loss. Treatment with ceftriaxone resolved symptoms and improved CSF abnormalities, demonstrating effective Lyme disease management.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Neuroborreliosis, a late manifestation of Lyme disease, can present with diverse neurological and ophthalmological symptoms.
- Early diagnosis and treatment are crucial for managing neuroborreliosis and preventing long-term sequelae.
Observation:
- A 65-year-old woman presented with low back pain, fever, and elevated inflammatory markers.
- She subsequently developed progressive visual loss and bilateral papilledema.
- Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, elevated protein, and oligoclonal bands, with positive Borrelia Burgdorferi serology.
Findings:
- Cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis (68 leukocytes/mm3), elevated protein (1.9 g/l), and oligoclonal bands.
- Serologic tests for Borrelia Burgdorferi were positive in both blood (1/64) and CSF (≥1/128).
- Intravenous ceftriaxone treatment led to rapid improvement in back pain and CSF parameters, with normalization within seven months.
Implications:
- This case highlights the importance of considering neuroborreliosis in patients with unexplained neurological and visual disturbances, especially in endemic areas.
- Prompt antibiotic treatment, such as with ceftriaxone, can effectively reverse neurological deficits and inflammatory markers associated with Lyme disease.
- Neuroborreliosis management requires a multidisciplinary approach involving neurology, infectious disease, and ophthalmology specialists for optimal patient outcomes.