11/18. central nervous system manifestations of lyme disease.We studied six patients with central nervous system manifestations of lyme disease. Weeks to years after the initial infection, behavioral changes, ataxia, and/or weakness in bulbar or peripheral muscles developed. Four of the six patients had a lymphocytic pleocytosis in the cerebrospinal fluid, and two of them had magnetic resonance imaging scans suggestive of demyelination. In a patient with a subacute encephalitis, a brain biopsy specimen showed microgliosis without an inflammatory infiltrate and spirochetes morphologically compatible with borrelia burgdorferi. All six patients had elevated antibody titers to B burgdorferi in serum, but none had selective concentration of specific antibody in the cerebrospinal fluid. All six patients were treated with high-dose intravenous penicillin; four had complete recoveries and two did not. lyme disease may affect the central nervous system causing organic brain disease or syndromes suggestive of demyelination.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
12/18. CNS-borreliosis selectively affecting central motor neurons.A patient is described having borrelia burgdorferi spirochetal infection clinically affecting central motor neurons selectively and without any sensory impairment. diagnosis was based on elevated B. burgdorferi IgG antibody titers in cerebrospinal fluid (CSF) and titer normalization at clinical recovery. This occurred promptly and was complete after penicillin treatment despite 14 months of progressive central nervous system (CNS) dysfunction, favouring the hypothesis of the presence of the organism within the CNS. CSF findings characteristic of neuroborreliosis were registered, including parallel occurrence of mononuclear pleocytosis, severe blood-brain barrier damage and marked CSF IgM index elevation of prolonged duration. Some earlier reports of CNS manifestations related to B. burgdorferi are reviewed.- - - - - - - - - - ranking = 1.5keywords = burgdorferi (Clic here for more details about this article) |
13/18. Chronic central nervous system involvement in Lyme borreliosis.We describe four patients with marked chronic meningoencephalomyelitis caused by tick-transmitted borrelia burgdorferi infection. Imaging techniques showed either MS-like lesions or evidence of vascular involvement, as in other spirochetal infections, especially in meningovascular syphilis.- - - - - - - - - - ranking = 0.5keywords = burgdorferi (Clic here for more details about this article) |
14/18. Basal meningovasculitis and occlusion of the basilar artery in two cases of borrelia burgdorferi infection.We present two cases in which a meningovasculitis and occlusion of the basilar artery were found in young adults with a borrelia burgdorferi infection. We introduce the designation "neuroborreliosis," because both the central and peripheral nervous systems can be involved in the infection.- - - - - - - - - - ranking = 2.5keywords = burgdorferi (Clic here for more details about this article) |
15/18. Chronic forms of borrelia burgdorferi infection of the nervous system.Three European patients had chronic active forms of borrelia burgdorferi infection of the nervous system, with high titers of antibodies to this spirochete in serum and CSF. Two patients had meningitis for 3 to 4 years, with remissions in one and slowly progressive symptoms in the other. Both had CT lucencies in the basal ganglia. The third patient had lumbosacral plexus neuropathy for 1 year. All three patients responded to intravenous penicillin treatment.- - - - - - - - - - ranking = 2.5keywords = burgdorferi (Clic here for more details about this article) |
16/18. Use of hyaluronidase in the central nervous system.Hyaluronidase, an enzyme which depolymerizes the mucopolysaccharide hyaluronic acid, appears to be tolerated by the human central nervous system and in the anterior chamber of the rabbit eye. Two patients with hydrocephalus and meningomyelocele had their condition curtailed by intraventricular injections of hyaluronidase, and in a third patient its use permitted delay of shunting. It was apparently effective in preventing a reaccumulation of cystic fluid in an intramedullary neurofibroma, and in reversing adverse effects of adhesive arachnoiditis of the spinal cord. Hylauronidase seems worthy of further investigation in disorders of the central nervous system.- - - - - - - - - - ranking = 0.0015957472983315keywords = lyme (Clic here for more details about this article) |
17/18. Detection of mycobacterium avium complex in cerebrospinal fluid of a sarcoid patient by specific polymerase chain reaction assays.The etiology of sarcoidosis is unknown, but it has long been suspected to be mycobacterial. In the present study, we used 4 mycobacterial species-specific polymerase chain reaction assays on cerebrospinal fluid obtained from a patient with neurosarcoidosis. Positive hybridization was observed with both the mycobacterium avium complex probe and the insertion element IS900-specific probe that has been found in M. paratuberculosis species. There was no hybridization with M. tuberculosis or M. avium woodpigeon strain-specific probes. This case report demonstrates that M. paratuberculosis or some closely related M. avium spp which perhaps also carry IS900, or contain closely related dna sequences, are associated with at least some cases of sarcoidosis disease.- - - - - - - - - - ranking = 0.0079787364916575keywords = lyme (Clic here for more details about this article) |
18/18. Clinical value of specific intrathecal production of antibodies.The production of intrathecal antibodies is considered a highly specific marker for an infection of the central nervous system (CNS), e.g. borreliosis or tick-borne encephalitis (TBE). To investigate the validity of this assumption, we examined records of patients who had been hospitalized between 1989 and 1995, who were tested for borreliosis (n = 8003) and TBE (n = 904) and whose cerebrospinal fluid (CSF) had subsequently tested positive for intrathecal production of antibodies. The time period between the beginning of the symptoms and the time of the CSF examination ranged from one day to six weeks. Seventy-seven patients showed a production of intrathecal antibodies against borrelia burgdorferi. Three of these patients were false positives with no history and no clinical signs of neuroborreliosis. In two cases, this was due to a non-specific cross-reaction caused by a preceding infection with syphilis. The third false positive was possibly caused by an earlier administration of immunoglobulins. Three patients showed a production of intrathecal antibodies against TBE virus. Two of these patients were false positives. In one case, we suspect that the production of intrathecal antibodies was caused by a non-specific immune reaction during an acute neuroborreliosis. One year earlier, the patient had contact with TBE virus through a vaccination against TBE. The cause of the second false positive is unclear, the clinical findings, acute encephalitis and the serological analysis suggest a cross-reaction with a virus similar to TBE. A specific intrathecal production of antibodies is not a proof for an infection of the CNS. In unclear cases, one should carry out a Western blot analysis or, if one suspects a case of TBE, a neutralization test.- - - - - - - - - - ranking = 0.5keywords = burgdorferi (Clic here for more details about this article) |
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