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[Acute polyradiculoneuritis and Lyme disease]

P Diraison1, G Lheveder, S Lanusse

  • 1Service de Neurologie, CHU La Cavale Blanche, Brest.

Revue Neurologique
|July 1, 1997
PubMed
Summary

Polyradiculoneuritis relapsed despite gammaglobulin treatment. Borrelia burgdorferi infection was identified, and antibiotic therapy led to improvement, suggesting distinct Lyme disease neurological presentations.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Polyradiculoneuritis is a neurological disorder characterized by widespread nerve inflammation.
  • Relapsing courses of polyradiculoneuritis can occur despite standard treatments like intravenous polyvalent gammaglobulin.

Observation:

  • A 33-year-old patient experienced recurrent polyradiculoneuritis episodes.
  • Following the second relapse, Borrelia burgdorferi infection was confirmed via positive serum and cerebrospinal fluid (CSF) titers.
  • Clinical symptoms and electrophysiological findings improved after initiating intravenous antibiotic treatment.

Findings:

  • The case highlights a potential link between Borrelia burgdorferi infection and relapsing polyradiculoneuritis.
  • Two distinct clinical and electrophysiological patterns of peripheral nervous system involvement in Lyme disease are proposed: meningoradiculoneuritis with axonal damage and polyradiculoneuritis with demyelination.

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Implications:

  • Early identification of Borrelia burgdorferi infection is crucial for managing relapsing polyradiculoneuritis.
  • Distinguishing between axonal and demyelinating presentations of neuroborreliosis can guide treatment strategies.
  • This case contributes to understanding the diverse neurological manifestations of Lyme disease.