ro13-9904 and Neuritis

Perineuritis is an unusual cause of direct peripheral nerve injury. We describe the clinicopathologic features of a 56-year-old man with mononeuritis multiplex due to Lyme disease; sural nerve biopsy demonstrated florid perineuritis. Treatment with intravenous ceftriaxone resulted in marked neurologic improvement. This study supports the notion that perineuritis forms part of the pathogenesis in acute Lyme neuroborreliosis.

Topics: Anti-Bacterial Agents; Arm; Axons; Biopsy; Ceftriaxone; Chemotaxis, Leukocyte; Humans; Immunosuppressive Agents; Leg; Lyme Neuroborreliosis; Male; Methylprednisolone; Middle Aged; Muscle Weakness; Neuritis; Peripheral Nerves; Sural Nerve; Treatment Outcome; Wallerian Degeneration

Lyme disease is an infectious disease caused by the spirochete Borrelia burgdorferi. The course of the disease is divided into three stages, the second of which may include various types of peripheral nervous system disturbances. We report the case of a patient with persistent deficits caused by the prevalent involvement of the sciatic nerve, confirmed by electrophysiological and neuropathological findings. The most significant bioptic results were axonal degeneration and perivascular inflammation. Damage to a single peripheral nerve as the dominant clinical expression during the course of Lyme disease is an unusual finding that has been rarely described in the literature.

Topics: Aged; Biopsy; Ceftriaxone; Cephalosporins; Electromyography; Female; Humans; Lyme Disease; Nerve Degeneration; Neuritis; Sciatic Nerve; Tomography, X-Ray Computed