Chapter 99 – Nervous system Lyme disease

摘要: Lyme disease, the multisystem infectious disease caused by tick-borne spirochete Borrelia burgdorferi involves nervous system in 10–15% of affected individuals. Manifestations include lymphocytic meningitis, cranial neuritis, radiculoneuritis, and mononeuropathy multiplex. Encephalopathy, identical to that seen many systemic inflammatory diseases, can occur during active infection. It is not specific only rarely evidence Diagnosis based on demonstration antibodies peripheral blood means two-tier testing with an ELISA Western blot. Central infection often results antibody production CSF, demonstrable comparing spinal fluid serologies. Treatment straightforward curative most instances. Many patients be treated effectively oral antibiotics such as doxycycline; severe CNS parenteral treatment ceftriaxone or other similar agents highly effective. should usually for 2 at 4 weeks. Longer adds no therapeutic benefit but does add substantial risk.