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Nervous system Lyme disease.
Handb Clin Neurol. 2014; 121:1473-83.HC

Abstract

Lyme disease, the multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi involves the nervous system in 10-15% of affected individuals. Manifestations include lymphocytic meningitis, cranial neuritis, radiculoneuritis, and mononeuropathy multiplex. Encephalopathy, identical to that seen in many systemic inflammatory diseases, can occur during active systemic infection. It is not specific to Lyme disease and only rarely is evidence of nervous system infection. Diagnosis of systemic disease is based on demonstration of specific antibodies in peripheral blood by means of two-tier testing with an ELISA and Western blot. Central nervous system infection often results in specific antibody production in the CSF, demonstrable by comparing spinal fluid to blood serologies. Treatment is straightforward and curative in most instances. Many patients can be treated effectively with oral antibiotics such as doxycycline; in severe CNS infection parenteral treatment with ceftriaxone or other similar agents is highly effective. Treatment should usually be for 2 to at most 4 weeks. Longer treatment adds no therapeutic benefit but does add substantial risk.

Authors+Show Affiliations

Department of Neurosciences, Overlook Medical Center, Summit, NJ, USA. Electronic address: john.halperin@atlantichealth.org.

Pub Type(s)

Historical Article
Journal Article
Review

Language

eng

PubMed ID

24365431

Citation

Halperin, John J.. "Nervous System Lyme Disease." Handbook of Clinical Neurology, vol. 121, 2014, pp. 1473-83.
Halperin JJ. Nervous system Lyme disease. Handb Clin Neurol. 2014;121:1473-83.
Halperin, J. J. (2014). Nervous system Lyme disease. Handbook of Clinical Neurology, 121, 1473-83. https://doi.org/10.1016/B978-0-7020-4088-7.00099-7
Halperin JJ. Nervous System Lyme Disease. Handb Clin Neurol. 2014;121:1473-83. PubMed PMID: 24365431.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nervous system Lyme disease. A1 - Halperin,John J, PY - 2013/12/25/entrez PY - 2013/12/25/pubmed PY - 2014/4/20/medline KW - Borrelia burgdorferi KW - Garin–Bujadoux–Bannwarth syndrome KW - Lyme borreliosis KW - Lyme disease KW - diagnosis KW - intrathecal antibody production KW - neuroborreliosis KW - treatment SP - 1473 EP - 83 JF - Handbook of clinical neurology JO - Handb Clin Neurol VL - 121 N2 - Lyme disease, the multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi involves the nervous system in 10-15% of affected individuals. Manifestations include lymphocytic meningitis, cranial neuritis, radiculoneuritis, and mononeuropathy multiplex. Encephalopathy, identical to that seen in many systemic inflammatory diseases, can occur during active systemic infection. It is not specific to Lyme disease and only rarely is evidence of nervous system infection. Diagnosis of systemic disease is based on demonstration of specific antibodies in peripheral blood by means of two-tier testing with an ELISA and Western blot. Central nervous system infection often results in specific antibody production in the CSF, demonstrable by comparing spinal fluid to blood serologies. Treatment is straightforward and curative in most instances. Many patients can be treated effectively with oral antibiotics such as doxycycline; in severe CNS infection parenteral treatment with ceftriaxone or other similar agents is highly effective. Treatment should usually be for 2 to at most 4 weeks. Longer treatment adds no therapeutic benefit but does add substantial risk. SN - 0072-9752 UR - https://www.unboundmedicine.com/medline/citation/24365431/Nervous_system_Lyme_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/B978-0-7020-4088-7.00099-7 DB - PRIME DP - Unbound Medicine ER -