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Chronic Central Nervous System Involvement

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Aspects of Lyme Borreliosis

Abstract

Although the meninges and nerve roots are more commonly involved during Lyme borreliosis, especially in Europe, numerous reports from Europe and the United States have documented the occurrence of acute and chronic manifestations in the brain or spinal cord (Ackermann et al. 1985; Klenk et al. 1985; Pfister et al. 1985; Reik et al. 1986; Kohlhepp et al. 1987; Behringer and Wirbatz 1987; Weder et al. 1987; Wokke et al. 1987a; Kohler et al. 1988; Halperin et al. 1989). The following chapter describes the clinical features and necessary investigations which help in the diagnosis of chronic central nervous system (CNS) involvement during Lyme borreliosis.

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References

  • Aberer E, Brunner C, Suchanek G, Klade H, Barbour A, Stanek G, Lassmann H (1989) Molecular mimicry and Lyme borreliosis: a shared antigenic determinant between Borrelia burgdorferi and human tissue. Ann Neurol 26:732–737

    Article  PubMed  CAS  Google Scholar 

  • Ackermann R, Gollmer E, Rehse-Küpper B (1985) Progressive Borrelien-Enzephalomyelitis. Dtsch Med Wochenschr 110:1039–1042

    Article  PubMed  CAS  Google Scholar 

  • Ackermann R, Rehse-Küpper B, Gollmer E, Schmidt R (1988) Chronic neurologic manifestations of erythema migrans borreliosis. Ann NY Acad Sci 539:16–23

    Article  PubMed  CAS  Google Scholar 

  • Barbour AG (1988) Laboratory aspects of Lyme borreliosis. Clin Microbiol Rev 1:399–414

    PubMed  CAS  Google Scholar 

  • Behringer A, Wirbatz A (1987) Chronische Borrelien-Erkrankung des zentralen Nervensystems. Nervenarzt 58:564–567

    PubMed  CAS  Google Scholar 

  • Bensch J, Oleen P, Hagberg L (1987) Destructive chronic Borrelia meningoencephalitis in a child untreated for 15 years. Scand J Infect Dis 19:697–700

    Article  PubMed  CAS  Google Scholar 

  • Burke JM, Schaberg DR (1985) Neurosyphilis in the antibiotic era. Neurology 35:1368–1371

    PubMed  CAS  Google Scholar 

  • Delpech B, Lichtblau E (1972) Étude quantitative des immunoglobulines G et de l’albumine du liquide céphalorachidien. Clin Chim Acta 37:15–23

    Article  PubMed  CAS  Google Scholar 

  • Hänny PE, Häuselmann HJ (1987) Die Lyme-Krankheit aus der Sicht des Neurologen. Schweiz Med Wochenschr 117:901–915

    PubMed  Google Scholar 

  • Halperin JJ, Luft BJ, Anand AK et al. (1989) Lyme borreliosis: central nervous system manifestations. Neurology 39:753–759

    PubMed  CAS  Google Scholar 

  • Hansen K, Rechnitzer C, Pedersen NS, Arpi M, Jessen O (1986) Borrelia meningitis in Denmark. Zentralbl Bakteriol Hyg (A) 263:348–350

    Google Scholar 

  • Henriksson A, Link H, Cruz M, Stiernstedt G (1986) Immunoglobulin abnormalities in cerebrospinal fluid and blood over the course of lymphocytic meningoradiculitis (Bannwarth’s syndrome). Ann Neurol 20:337–345

    Article  PubMed  CAS  Google Scholar 

  • Klenk W, Heitmann R, Ackermann R (1985) Rezidivierende Erythema-Chronicum-Migrans- Krankheit des Nervensystems: Querschnittsmyelitis als Rückfall einer Meningopolyneuritis Garin-Bujadoux-Bannwarth. Akt Neurol 12:20–23

    Article  Google Scholar 

  • Kohler J, Kern U, Kasper J, Rhese-Küpper B, Thoden U (1988) Chronic central nervous system in Lyme borreliosis. Neurology 38:863–867

    PubMed  CAS  Google Scholar 

  • Kohlhepp W, Mertens HG, Oschmann P, Rohrbach E (1987) Akute und chronische Erkrankungen bei zeckenvermittelter Borreliose. Nervenarzt 58:557–563

    PubMed  CAS  Google Scholar 

  • Kohlhepp W, Kuhn W, Krüger H (1989) Extrapyramidal features in central Lyme borreliosis. Eur Neurol 29:150–155

    Article  PubMed  CAS  Google Scholar 

  • Kollikowski HH, Schwendemann G, Schulz M, Wilhelm H, Lehmann HJ (1988) Chronic Borrelia encephalomyeloradiculitis with severe mental disturbance: immunosuppressive versus antibiotic therapy. J Neurol 235:140–142

    Article  PubMed  CAS  Google Scholar 

  • Krüger H, Reuss K, Pulz M, Rohrbach E, Pflughaupt KW, Martin R, Mertens HG (1989) Meningoradiculitis and encephalomyelitis due to Borrelia burgdorferi: a follow-up study of 72 patients over 27 years. J Neurol 236:322–328

    Article  PubMed  Google Scholar 

  • Macdonald AB, Miranda JM (1987) Concurrent neocortical borreliosis and Alzheimer’s disease. Hum Pathol 18:749–761

    Article  Google Scholar 

  • Martin R, Martens U, Sticht-Groh V, Dörries R, Krüger H (1988a) Persistent intrathecal secretion of oligoclonal, Borrelia burgdorferi-specific IgG in chronic meningoradiculitis. J Neurol 235:229–233

    Article  PubMed  CAS  Google Scholar 

  • Martin R, Ortlauf J, Sticht-Groh V, Bogdahn U, Goldmann SF, Mertens HG (1988b) Borrelia burgdorferi-specific and autoreactive T cell lines from cerebrospinal fluid in Lyme radicu- lomyelitis. Ann Neurol 24:509–516

    Article  PubMed  CAS  Google Scholar 

  • Martin R, Meinck HM, Schulte-Mattler W, Ricker K, Mertens HG (1990) Borrelia burgdorferi myelitis presenting as a partial stiff-man syndrome. J Neurol 237:51–54

    Article  PubMed  CAS  Google Scholar 

  • May EF, Jabbari B (1990) Stroke in neuroborreliosis. Stroke 21:1232–1235

    Article  PubMed  CAS  Google Scholar 

  • Mertens HG, Kohlhepp W, Martin R (1989) Die Borrelienenzephalitis und -myelitis. In Fischer PA, Baas H, Enzensberger W (eds) Gerontoneurologie, Enzephalitiden, Neurogenetik. Springer, Berlin Heidelberg New York, pp 396–407 (Verhandlungen der Deutschen Gesellschaft für Neurologie, vol. 5)

    Google Scholar 

  • Midgard R, Hofstad H (1987) Unusual manifestations of nervous system Borrelia burgdorferi infection. Arch Neurol 44:781–783

    PubMed  CAS  Google Scholar 

  • Murray N, Kristoferitsch W, Stanek g, Steck AJ (1986) Specificity of CSF antibodies against components of Borrelia burgdorferi in patients with meningopolyneuritis Garin-Bujadoux-Bannwarth. J Neurol 233:224–227

    Article  PubMed  CAS  Google Scholar 

  • Pachner AR (1989) Lyme disease. TINS 12:177–181

    PubMed  CAS  Google Scholar 

  • Pachner AR, Steere AC, Sigal LH, Johnson CJ (1985) Antigen-specific proliferation of CSF lymphocytes in Lyme disease. Neurology 35:1642–1644

    PubMed  CAS  Google Scholar 

  • Pachner AR, Duray P, Steere AC (1989) Central nervous system manifestations of Lyme disease. Arch Neurol 46:790–795

    PubMed  CAS  Google Scholar 

  • Papolla MA, Omar R, Saran B, Andorn A, Suarez M, Pavia C, Weinstein A, Shank D, Davis K, Burgdorfer W (1989) Concurrent neuroborreliosis and Alzheimer’s disease: analysis of evidence. Hum Pathol 20:753–757

    Article  Google Scholar 

  • Pfister HW, Einhäupl K, Preac-Mursic V, Wilske B, Schierz G (1984) The spirochetal etiology of lymphocytic eningoradiculitis of Bannwarth (Bannwarth’s syndrome). J Neurol 231: 141–144

    Article  PubMed  CAS  Google Scholar 

  • Pfister HW, Einhäupl K, Preac-Mursic V, Wilske B (1985) Lyme disease: commentary from Europe. Similarity of neurologic manifestations of Borrelia burgdorferi infections in America and Europe. Neurology 35:1393–1394

    Google Scholar 

  • Pfister HW, Preac-Mursic V, Wilske B, Einhäupl KM, Weinberger K (1989) Latent Lyme neuroborreliosis: presence of Borrelia burgdorferi in the cerebrospinal fluid without concurrent inflammatory signs. Neurology 39:1118–1120

    PubMed  CAS  Google Scholar 

  • Pflüger KH, Reimers CD, Neubert U et al. (1988) Erythema migrans borreliosis: an HLA-associated disease? Ann NY Acad Sci 539:414–416

    Article  Google Scholar 

  • Reiber H (1980) The discrimination between different blood-CSF barrier dysfunctions and inflammatory reactions of the CNS by a recent evaluation graph for the protein profile of cerebrospinal fluid. J Neurol 224:89–99

    Article  PubMed  CAS  Google Scholar 

  • Reik L, Smith L, Khan A, Nelson W (1985) Demyelinating encephalopathy in Lyme disease. Neurology 35:267–269

    PubMed  Google Scholar 

  • Reik L, Burgdorfer W, Donaldson JO (1986) Neurologic abnormalities in Lyme disease without erythema chronicum migrans. Am J Med 81:73–78

    Article  PubMed  Google Scholar 

  • Rosa PA, Schwan TG (1989) A specific and sensitive assay for the Lyme disease spirochete Borrelia burgdorferi using the polymerase chain reaction. J Infect Dis 160:1018–1029

    Article  PubMed  CAS  Google Scholar 

  • Rowland LP (ed) (1989) Textbook of neurology, 8th edn. Lea and Febiger (Philadelphia), pp 152–161

    Google Scholar 

  • Rousseau JJ, Lust C, Zangerle PF, Bigaignon G (1986) Acute transverse myelitis as presenting neurological feature of Lyme disease. Lancet II: 1222–1223

    Article  Google Scholar 

  • Schaltenbrand G (1962) Radikulomyelomeningitis nach Zeckenbiss. Munch Med Wochenschr 18:829–834

    Google Scholar 

  • Schlüsener HJ, Martin R, Sticht-Groh V (1989) Autoimmunity in Lyme disease: molecular cloning of antigens recognized by antibodies in the cerebrospinal fluid. Autoimmunity 2:323–330

    Article  Google Scholar 

  • Steere AC (1989) Lyme disease. N Engl J Med 321:586–596

    Article  PubMed  CAS  Google Scholar 

  • Steere AC, Hardin JA, Ruddy S, Mummaw JG, Malawista SE (1979) Lyme arthritis: correlation of serum and cryoglobulin I with activity, and serum I with remission. Arthritis Rheum 22:471–483

    Article  PubMed  CAS  Google Scholar 

  • Sticht-Groh V, Martin R, Schmidt-Wolf I (1988) Antibody titer determinations against Borrelia burgdorferi in blood donors and in two different groups of patients. Ann NY Acad Sci 539:497–499

    Article  Google Scholar 

  • Stiernstedt G, Sköldenberg B, Vandvik B et al. (1984) Chronic meningitis and Lyme disease in Sweden. Yale J Biol Med 57:491–497

    PubMed  CAS  Google Scholar 

  • Suchanek G, Kristoferitsch W, Stanek G, Bernheimer H (1986) Anti-myelin antibodies in cerebrospinal fluid and serum of patients with meningopolyneuritis Garin-Bujadoux-Bannwarth and other neurological diseases. Zentralbl Bakteriol Hyg (A) 263:160–168

    CAS  Google Scholar 

  • Uldry PA, Regli F, Bogousslavsky J (1987) Cerebral angiopathy and recurrent strokes following Borrelia burgdorferi infection. J Neurol Neurosurg Psychiatry 50:1703–1704

    Article  PubMed  CAS  Google Scholar 

  • Vandvik B, Sköldenberg B, Stiernstedt G (1984) Tick-borne spirochetal meningitis, meningoradiculitis and meningoencephalitis. A report on 15 cases identified by demonstration of intrathecal spirochete-specific I antibody responses. Acta Neurol Scand 70:379–380

    Google Scholar 

  • Veenendaal-Hilbers JA, Perquin WVM, Hoogland PH, Doornbos L (1988) Basal meningovascu- litis and occlusion of the basilar artery in two cases of Borrelia burgdorferi infection. Neurology 38:1317–1319

    PubMed  CAS  Google Scholar 

  • Weber K, Bratzke H-J, Neubert U, Wilske B, Duray PH (1988) Borrelia burgdorferi in a newborn despite oral penicillin for Lyme borreliosis during pregnancy. Pediatr Infect Dis J 7:286–289

    Article  PubMed  CAS  Google Scholar 

  • Weder B, Wiedersheim P, Matter L, Steck A, Otto F (1987) Chronic progressive neurological involvement in Borrelia burgdorferi infection. J Neurol 234:40–43

    Article  PubMed  CAS  Google Scholar 

  • Wilske B, Schierz G, Preac-Mursic V et al. (1986) Intrathecal production of specific antibodies against Borrelia burgdorferi in patients with lymphocytic meningoradiculitis (Bannwarth’s syndrome). J Infect Dis 153:304–313

    Article  PubMed  CAS  Google Scholar 

  • Wokke JHJ, van Gijn J, Elderson A, Stanek G (1987a) Chronic forms of Borrelia burgdorferi infection of the nervous system. Neurology 37:1031–1034

    PubMed  CAS  Google Scholar 

  • Wokke JHJ, de Koning J, Stanek G, Jennekens FGI (1987b) Chronic muscle weakness by Borrelia burgdorferi meningoradiculitis. Ann Neurol 22:389–392

    Article  PubMed  CAS  Google Scholar 

  • Wokke JHJ, van Doom PA, Brand A, Schreuder GMT, Vermeulen M (1988) Association of HLA-DR antigen with serum I antibodies against Borrelia burgdorferi in Bannwarth’s syndrome. J Neurol 235:415–417

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. R. Martin
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  2. W. Kohlhepp
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  3. H. G. Mertens
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Editor information

Editors and Affiliations

  1. Rosenstr.6, 8000, München 2, Germany

    Klaus Weber (Dermatologist in Private Practice) (Dermatologist in Private Practice)

  2. Laboratory of Vectors and Pathogens, Rocky Mountain Laboratories, Department of Health and Human Services, Public Health Service,National Institutes of Health, National Institute of Allergy and Infectious Diseases, 59840, Hamilton, MT, USA

    Willy Burgdorfer Ph.D.,M.D.(h.c.)

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© 1993 Springer-Verlag Berlin Heidelberg

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Martin, R., Kohlhepp, W., Mertens, H.G. (1993). Chronic Central Nervous System Involvement. In: Weber, K., Burgdorfer, W., Schierz, G. (eds) Aspects of Lyme Borreliosis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77614-4_15

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  • DOI: https://doi.org/10.1007/978-3-642-77614-4_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-77616-8

  • Online ISBN: 978-3-642-77614-4

  • eBook Packages: Springer Book Archive

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