ro13-9904 and Polyradiculopathy

Topics: Anti-Bacterial Agents; Ceftriaxone; Dexamethasone; Empyema, Subdural; Humans; Magnetic Resonance Imaging; Male; Meningitis, Meningococcal; Neisseria meningitidis; Penicillin G; Polyradiculopathy; Serogroup; Vancomycin; Young Adult

Borreliosis has been widely recognized in Switzerland and is often used in unclear cases with non-specific symptoms. Two illustrative cases should emphasize the current options for diagnosis and therapy of neuroborreliosis. The keystones of the diagnostic instruments are a history with typical symptoms and analysis of the cerebrospinal fluid with determination of appropriate antibodies. Therapy deals with ceftriaxon with intravenous and doxycyclin with oral application making ambulatory treatment possible.

Topics: Administration, Oral; Aged; Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi; Ceftriaxone; Diagnosis, Differential; Doxycycline; Facial Paralysis; Humans; Infusions, Intravenous; Lyme Neuroborreliosis; Male; Polyradiculoneuropathy; Polyradiculopathy

Demyelinating neuropathy is considered a rare complication of Lyme borreliosis. We report a case of meningoradiculitis due to Borrelia burgdorferi in which the neurophysiological analysis showed evidence of restricted demyelinating involvement of the nerve roots and plexus, with no peripheral involvement or signs of distal axonal lesions. Lyme disease, therefore, can in fact be associated with demyelinating polyradiculitis with no peripheral nerve damage.

Topics: Aged; Borrelia burgdorferi Group; Ceftriaxone; Demyelinating Diseases; Humans; Injections, Intravenous; Lyme Disease; Male; Polyradiculopathy; Treatment Outcome

In general, meningopolyradiculitis (Bannwarth's syndrome, stage 2 of neuroborreliosis) follows a predictable monophasic self-limiting course. In contrast, we report the case of a patient with an untreated meningopolyradiculitis which evolved into acute schizophrenia-like psychosis due to persistent infection with Borrelia burgdorferi. The psychosis resolved within 1 week of treatment with ceftriaxone. This case shows that the usually benign monophasic meningopolyradiculitis may progress to severe CNS complications, which may have implications on current pathophysiological beliefs.

Topics: Acute Disease; Antibodies, Bacterial; Borrelia burgdorferi Group; Ceftriaxone; Chronic Disease; Diagnosis, Differential; Encephalitis; Humans; Immunoglobulin G; Lyme Disease; Male; Meningitis; Middle Aged; Neurocognitive Disorders; Polyradiculopathy; Schizophrenia; Syndrome