Oral treatment of parenchymal central nervous system neuroborreliosis – are we there yet?

Abstract

Click http://onlinelibrary.wiley.com/doi/10.1111/ene.12420/abstract to view the accompanying paper in this issue.

Cerebrovascular Events in Lyme Neuroborreliosis

“…All our patients received intravenous ceftriaxone as first-line treatment, but oral doxycycline has been reported as being effective to treat neuroborreliosis with central nervous involvement. 8,47 The prognosis of patients with neuroborreliosis-related strokes appears to be worse than for stroke of other origin, perhaps because it is the more serious cases that tend to be more diagnosed and reported. Nevertheless, short-term outcome in our 5 cases was favorable under treatment, and the patients' clinical states quickly improved.…”

Nervous System Lyme Disease

“…However, a recent European study suggests this may be effective in many instances [48•] and provides enough evidence of equipoise to warrant more detailed study [49].…”

Medically Refractory Neuroborreliosis Case Presented with Coexistance Involvements of Cranial 7 and 8 Nerves

“…PNS involvement of cranial or peripheral nerves is the more common neurological finding and occurs in roughly 10% of infected untreated patients [4,6,7,9,10]. Radiculitis or inflammation of the nerve root can be seen 3-5% of the time in acute neuroborreliosis, affecting the PNS with a typical presentation involving intractable pain, as well as muscle denervation and areflexia over one or a few adjacent dermatomes [11]. Meningitis affecting the CNS is usually seen 1% of the time, these cases may present variable symptoms, and in rare cases, patients may develop brain parenchyma or spinal cord inflammation [4,5,9,[12][13][14].…”