ro13-9904 and Dementia

Dementia-like syndromes are rare manifestations of Lyme neuroborreliosis. The clinical patterns are summarized using our own cases and case reports from the literature, which were diagnosed as definite Lyme neuroborreliosis according to the European guidelines. The cases disclose signs of subcortical dementia that occur more rapidly than in patients suffering from primary dementia. Gait disturbances early in the disease course is another frequently observed characteristic feature. The response to 2-4 weeks of antibiotic treatment with ceftriaxone was excellent. There were no indications for a prolonged antibiotic treatment. It is essential to be aware of this manifestation of Lyme neuroborreliosis, because early antibiotic treatment will prevent permanent sequelae that may occur throughout the further course of the untreated disease.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Ceftriaxone; Cognitive Dysfunction; Dementia; Female; Humans; Lyme Disease; Lyme Neuroborreliosis

Dementia with Lewy bodies (DLB) is characterized by neuronal deficits and

Topics: alpha-Synuclein; Animals; Brain; Ceftriaxone; China; Dementia; Disease Models, Animal; Hippocampus; Lewy Bodies; Lewy Body Disease; Magnetic Resonance Imaging; Male; Neurodegenerative Diseases; Neurons; Rats; Rats, Wistar

Topics: Aged; Anti-Bacterial Agents; Biomarkers; Borrelia burgdorferi; Brain; Ceftriaxone; Dementia; Diagnosis, Differential; Female; Humans; Hydrocephalus, Normal Pressure; Lyme Neuroborreliosis; Treatment Outcome

Both ceftriaxone (CEF) and erythropoietin (EPO) show neuroprotection and cognitive improvement in neurodegenerative disease. The present study was aimed at clarifying whether combined treatment with CEF and EPO (CEF+EPO) had superior neuroprotective and behavioral effects than treatment with CEF or EPO alone in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease (PD) rat model. The rats were injected with CEF (5 mg/kg/day), EPO (100 IU/kg/day), or CEF+EPO after MPTP lesioning and underwent the bar-test, T-maze test, and object recognition test, then the brains were taken for histological evaluation. MPTP lesioning resulted in deficits in working memory and in object recognition, but the cognitive deficits were markedly reduced or eliminated in rats treated with CEF or CEF+EPO, with the combination having a greater effect. Lesioning also caused neurodegeneration in the nigrostriatal dopaminergic system and the hippocampal CA1 area and these changes were reduced or eliminated by treatment with CEF, EPO, or CEF+EPO, with the combination having a greater effect than single treatment in the densities of DAergic terminals in the striatum and neurons in the hippocampal CA1 area. Thus, compared to treatment with CEF or EPO alone, combined treatment with CEF+EPO had a greater inhibitory effect on the lesion-induced behavioral and neuronal deficits. To our knowledge, this is the first study showing a synergistic effect of CEF and EPO on neuroprotection and improvement in cognition in a PD rat model. Combined CEF and EPO treatment may have clinical potential for the treatment of the dementia associated with PD.

Topics: Animals; Antiparkinson Agents; Brain; Ceftriaxone; Cognition; Dementia; Drug Synergism; Drug Therapy, Combination; Erythropoietin; Male; Memory; Neuroprotective Agents; Nootropic Agents; Parkinsonian Disorders; Pyramidal Cells; Rats, Wistar; Treatment Outcome

We herein report a heterosexual Japanese man in his forties who had been suffering from advanced dementia and personality change for 4 years. Positive results of a serological test for syphilis, Treponema pallidum hemagglutination assay, and fluorescent treponemal antibody-absorption test of both serum and cerebral spinal fluid led to the diagnosis of neurosyphilis. Jarisch-Herxheimer reaction was seen shortly after the first dose of penicillin was administered to the patient. His cognitive function did not recover after treatment. The incidence of syphilis has been reported to be increasing. Neurosyphilis should not be overlooked as an etiology for progressive dementia even in this post-antibiotic era.

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Ceftriaxone; Cognition Disorders; Dementia; Hemagglutination Tests; Humans; Incidence; Male; Mental Disorders; Neurosyphilis; Penicillin G; Treponema pallidum

We wanted to compare the first line intravenous administration of ceftriaxone to a subcutaneous administration in patients more than 75 years of age.. We performed a retrospective monocentric study on all patients more than 75 years of age admitted to the Ales hospital between January 1 and December 31, 2011, having received at least two doses of ceftriaxone intravenously (IV) or subcutaneously (SC).. One hundred and forty-eight patients (70 females/78 males patients) were included, 110 received ceftriaxone IV and 38 SC. They were a mean age of 84.7 years, older in the SC group (86.9 years) than in the IV group (83.9 years) (P = 0.0052). The SC group patients presented more frequently with dementia (57% vs. 25% P = 0.001), were more often bedridden (22% vs. 7% P = 0.023), had a higher mean World Health Organization status (3.13 vs. 2.76, P = 0.0181), and higher ADL score (7.79 vs. 5.76, P = 0.0056). There was no statistical difference for isolated bacteria, site of infection, death rate, and patients cured.. Subcutaneous ceftriaxone administration seems to be preferred for fragile elderly patients independently of disease severity. This administration is not associated to an impaired effectiveness or to an increased death rate.

Topics: Activities of Daily Living; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Blood Coagulation Disorders; Ceftriaxone; Comorbidity; Dementia; Female; Frail Elderly; Hospital Mortality; Hospital Units; Humans; Injections, Intravenous; Injections, Subcutaneous; Kidney Diseases; Male; Mental Disorders; Retrospective Studies

A 69-year old patient who had been treated for joint pain over a long time was admitted because of weight loss and dementia. He was confused and cachectic with edema and skin hyperpigmentation.. Laboratory findings indicated chronic infection. Duodenal biopsy revealed Whipple's disease. The PCR of cerebrospinal fluid for Tropheryma whipplei was negative.. During treatment with ceftriaxon and intravenous fluid therapy the patient's mental state improved. However his motoric state remained insufficient.. Whipple's disease should be considered in dementia, even more in previous "rheumatic symptoms", in order to avoid ineffective (immunosuppressive) treatment with unfortunate consequences.

Topics: Aged; Anti-Bacterial Agents; Biopsy; Ceftriaxone; Colonoscopy; Combined Modality Therapy; Dementia; Diagnosis, Differential; Duodenum; Endoscopy, Digestive System; Fluid Therapy; Humans; Intestinal Mucosa; Male; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography; Whipple Disease

Topics: Amygdala; Anti-Bacterial Agents; Anti-Infective Agents; Ceftriaxone; Dementia; Diagnosis, Differential; Female; Humans; Kluver-Bucy Syndrome; Magnetic Resonance Imaging; Middle Aged; Paresis; Temporal Lobe; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Whipple Disease

An 80-year-old woman presented with progressive cognitive decline and with a 6-month history of gait ataxia. Brain MRI depicted enlarged ventricles and periventricular lesions. Clinical improvement after CSF spinal tap test suggested a normal pressure hydrocephalus syndrome. But CSF pleocytosis with activated lymphocytes and plasma cells and intrathecal Borrelia burgdorferi specific antibody production led to the diagnosis of active Lyme neuroborreliosis. Clinical symptoms of NPH resolved after a course of ceftriaxone.. Neurological examination, MMSE, brain MRI, lumbar puncture, spinal tap test.. Dementia due Borrelia burgdorferi infection with chronic meningitis was reversible after treatment with iv.2 g ceftriaxone per day for 4 weeks.. Rare but treatable dementias must be diagnosed promptly to slow down or even reverse cognitive decline.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Ceftriaxone; Dementia; Diagnosis, Differential; Female; Gait Ataxia; Humans; Hydrocephalus, Normal Pressure; Lyme Neuroborreliosis; Magnetic Resonance Imaging; Mental Status Schedule; Neurologic Examination; Time Factors; Treatment Outcome

Many different neurological conditions may be seen in the later stages of Lyme's Disease, such as blindness, epileptic crises, CVA, extrapyramidal disorders, amyotrophic lateral sclerosis, and dementia may be yet another form of presentation of chronic infection due to Borrelia burgdorferi (Bb). Progressive Supranuclear Paralysis (PSP), a disorder of unknown aetiology, considered to be the commonest cause of Parkinsonism-plus, one of the symptoms of which is dementia, has never been mentioned in this type of differential diagnosis.. We present the case of a 78 year old man with sub-acute mental deterioration, Bb positive serology in both plasma and CSF, and with clinical and epidemiological features compatible with Lyme's Disease. Complementary tests were negative. The syndrome corresponded to Lyme's Disease and improved after treatment with ceftriaxona.. We consider aspects of the aetiology of PSP which are still not clear. In our patient, the aetiology seemed to be Bb infection, according to the criteria of the original description of the disease and in view of the neuropathological findings which have shown Bb in the substancia nigra of the mid-brain and the existence of an animal model in which Bb shows a particular tendency to colonize infratentorial structures.

Topics: Aged; Antiparkinson Agents; Borrelia burgdorferi Group; Ceftriaxone; Cephalosporins; Dementia; Electroencephalography; Facies; Frontal Lobe; Humans; Lyme Disease; Magnetic Resonance Imaging; Male; Parietal Lobe; Substantia Nigra; Supranuclear Palsy, Progressive; Temporal Lobe; Tomography, Emission-Computed, Single-Photon

A 74-year-old woman presented with gait impairment, urinary incontinence, and dementia. She showed lymphocytic CSF pleocytosis and pronounced intrathecal Borrelia burgdorferi antibody production, indicating active Lyme neuroborreliosis. The syndrome of normal-pressure hydrocephalus (NPH) fully remitted after ceftriaxone treatment. Lyme neuroborreliosis may cause NPH by interfering with subarachnoid CSF flow.

Topics: Aged; Ataxia; Ceftriaxone; Cerebrospinal Fluid; Dementia; Female; Humans; Hydrocephalus, Normal Pressure; Leukocyte Count; Lyme Disease; Rheology; Urinary Incontinence