A 34-year-old woman presented to the medical admissions unit with progressive ascending weakness of her limbs and areflexia. Diagnosis of Guillain-Barré syndrome was suspected and she was started on intravenous immunoglobulins. Owing to a poor initial response, further exploratory history revealed travel to the New Forest and a possible tick bite; subsequent investigations confirmed positive serology for antibodies against Borrelia. The patient's weakness improved with intravenous ceftriaxone for neuroborreliosis, a manifestation of Lyme disease. With inpatient neurorehabilitation, she made good recovery and was able to mobilise with a stick from being completely bed bound 6 weeks after completion of her antibiotics.
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http://dx.doi.org/10.1136/bcr-2014-209080 | DOI Listing |
Trop Med Infect Dis
January 2025
Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada.
The causative agent of Lyme disease, , is endemic to Canada, the northeastern United States, northern California, and temperate European regions. It is rarely associated with a travel-related exposure. In this report, we describe a resident of southern Ontario, Canada who developed rash, fever, and cranial nerve VII and XII palsies following a 12 day trip to Ecuador and the Galapagos islands approximately four weeks prior to referral to our center.
View Article and Find Full Text PDFTher Adv Neurol Disord
January 2025
Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Background: Serum neurofilament light chain (sNfL) is a biomarker for neuro-axonal injury.
Objectives: To assess sNfL's utility as a diagnostic marker for Lyme neuroborreliosis (LNB).
Methods: We compared serum and CSF NfL levels in LNB patients and age-matched controls.
Neurology
February 2025
Clinic of Neurology and Neurophysiology, Medical Center, Faculty of Medicine, University of Freiburg, Germany; and.
True seronegativity is extremely rare in Lyme neuroborreliosis (LNB) with reports only in patients with hematological malignancies or under treatment with chemotherapy and B-cell depleting therapies. In these instances, diagnosing LNB can be challenging. We report the case of a 63-year-old patient with 2 independent episodes of LNB.
View Article and Find Full Text PDFEur J Neurol
January 2025
Department of Clinical Laboratory and Internal Medicine, National Center of Neurology and Psychiatry, Tokyo, Japan.
Background And Purpose: Clinical manifestations of Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato (Bbsl), include erythema migrans, Lyme neuroborreliosis (LNB), carditis, and arthritis. LB is a notifiable disease in Japan with <30 surveillance-reported LB cases annually, predominately from Hokkaido Prefecture. However, LB, including LNB, may be under-diagnosed in Japan since diagnostic tests are not readily available.
View Article and Find Full Text PDFCureus
December 2024
Neurology and Neuroscience, Medical University of Varna, Varna, BGR.
Neuromyelitis optica spectrum disorder (NMOSD) includes conditions with autoimmune genesis, which are manifested by attacks of optic neuritis (ON) and transverse myelitis (TM), and also express aquaporin 4 (NMO-IgG) or myelin oligo-endocytic glycoprotein (MOGAb) antibodies. In rare cases, the disease may also have a clinical presentation with only TM, without ON or with ON, without TM. These conditions are also included in the spectrum.
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