Autonomous dysfunction in Lyme neuroborreliosis. A case report

Hansen, Bent-Are; Finjord, Torgeir; Bruserud, Øyvind

doi:10.1002/ccr3.1494

Cited by 7 publications

(5 citation statements)

References 9 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There have been many case reports in the past highlighting the atypical presentation of Lyme disease including, but not limited to pseudo-obstruction, constipation, back pain radiating to abdomen (radiculoneuritis) known as Bannwarth Syndrome [1,3] as a manifestation of autonomic dysfunction related to neuroborreliosis [4]. There have been case reports of radiculo-neuritis causing abdominal pain as being misdiagnosed as herpes zoster [5] as seen in our case. Our patient was also misdiagnosed initially and started on valacyclovir for suspected herpes zoster as her burning lower back pain radiating to abdomen was suggestive of it.…”

Section: Discussionmentioning

confidence: 63%

The many manifestations of a single disease: neuroborreliosis

Zulfiqar

Qureshi

Dande

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Lyme disease is a tick-borne illness that occurs in stages, multiple organs and tissue with highly variable clinical presentation. Most commonly, it presents with seventh cranial nerve palsy, often mimicking stroke and atypical rash (erythema migrans). Atypical presentations include abdominal pain, ileus/pseudo-obstruction and constipation thought to be due to autonomic dysfunction. Other less common presentations include Syndrome of Inappropriate Antidiuretic Hormones (SIADH). Lyme disease should be a differential when a patient presents from Lyme endemic areas with abdominal pain, constipation and SIADH in the setting of other causes of gastrointestinal and renal symptoms ruled out. Here we present a case of multisystem involvement in a single patient with Lyme Disease along with neuroborreliosis (neurological manifestation of Lyme disease).

show abstract

Section: Discussionmentioning

confidence: 63%

The many manifestations of a single disease: neuroborreliosis

Zulfiqar

Qureshi

Dande

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

show abstract

“…Radiculoneuritis involving one or several dermatomes is another painful complication, and this may be accompanied by muscle weakness [ 10 ]. On rare occasions, Lyme disease may cause chronic epigastric pain [ 6 ] as well as chronic diarrhea and ulcerative colitis [ 11 ] possibly accompanied by anxiety [ 6 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Case Reports in Nephrology Case Reports in Nephrology chronic diarrhea and ulcerative colitis [11] possibly accompanied by anxiety [6,11].…”

Section: Discussionmentioning

confidence: 99%

“…Single symptom manifestations may be more common, but subsets of patients may present with an obscure mix of symptoms delaying the diagnosis. Enteroparesis causing constipation and ileus and urinary retention are extremely rare conditions associated with Lyme disease; only a few cases of SIADH have been reported [4][5][6][7][8][9]. We herein present a patient who developed an unusual combination of symptoms, which resolved after treatment of his Lyme disease was initiated.…”

Section: Introductionmentioning

confidence: 90%

See 1 more Smart Citation

A Patient with SIADH, Urinary Retention, Constipation, and Bell’s Palsy following a Tick Bite

Leone¹,

Iqbal²,

Bonatti³

et al. 2022

Case Reports in Nephrology

View full text Add to dashboard Cite

Introduction. Lyme disease is the most common vector borne disease in the USA caused by the bacterium Borrelia burgdorferi. If untreated, Lyme disease can cause a variety of secondary symptoms often difficult to interpret. Some of the rare manifestations of Lyme disease include SIADH-like syndrome, enteroparesis, and urinary retention. Case Report. A 69-year-old male presented with anorexia and constipation and was found to have hyponatremia. Several days after admission, Bell’s palsy developed and he experienced urinary retention requiring catheterization. Lyme disease was confirmed on serology, and he recalled a rash on his elbow four weeks prior. Ceftriaxone was started and the patient improved; he had multiple bowel movements after receiving laxatives and the Foley catheter was removed; serum sodium normalized with fluid restriction. He was discharged home and was well with symptoms completely resolved at three-month follow-up. Discussion. There should be a high alert of atypical presentation of this common tick bite associated infection. Review of the literature revealed ten similar cases, but only three of these patients were reported to have a combination of SIADH, urinary retention, and enteroparesis.

show abstract

“…Despite reports suggesting that the autonomic nervous system can also be affected, this complication of Lyme disease has received little attention. Case reports of autonomic disorders that have been reported after acute B. burgdorferi infection ( 23 , 24 ) include intestinal pseudo-obstruction ( 25 – 27 ), constipation ( 28 – 30 ), unexplained urinary retention ( 28 , 29 ), postural orthostatic tachycardia syndrome ( 24 , 31 ), and reflex sympathetic dystrophy ( 32 ), which is an autonomic disorder characterized by regional sympathetic hyperactivity. Although there are other causes of urinary retention, the co-existence with enteroparesis in five of these reports implicates dysfunction of the autonomic nervous system.…”

Section: Acute Infection With B Burgdorferi Can Al...mentioning

confidence: 99%

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?

Adler,

Chung,

Rowe

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

Dysautonomia, or dysfunction of the autonomic nervous system (ANS), may occur following an infectious insult and can result in a variety of debilitating, widespread, and often poorly recognized symptoms. Dysautonomia is now widely accepted as a complication of COVID-19 and is an important component of Post-Acute Sequelae of COVID-19 (PASC or long COVID). PASC shares many overlapping clinical features with other infection-associated chronic illnesses including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Treatment Lyme Disease Syndrome (PTLDS), suggesting that they may share common underlying mechanisms including autonomic dysfunction. Despite the recognition of this complication of Lyme disease in the care of patients with PTLD, there has been a scarcity of research in this field and dysautonomia has not yet been established as a complication of Lyme disease in the medical literature. In this review, we discuss the evidence implicating Borrelia burgdorferi as a cause of dysautonomia and the related symptoms, propose potential pathogenic mechanisms given our knowledge of Lyme disease and mechanisms of PASC and ME/CFS, and discuss the diagnostic evaluation and treatments of dysautonomia. We also outline gaps in the literature and priorities for future research.

show abstract

Autonomous dysfunction in Lyme neuroborreliosis. A case report

Abstract: Key Clinical MessageThe diagnosis of Lyme neuroborreliosis should be considered whenever a patient presents with neurological symptoms and comes from an endemic area. However, atypical clinical presentation occurs including gastrointestinal manifestations because of autonomous dysfunction.

Cited by 7 publications

References 9 publications

The many manifestations of a single disease: neuroborreliosis

The many manifestations of a single disease: neuroborreliosis

A Patient with SIADH, Urinary Retention, Constipation, and Bell’s Palsy following a Tick Bite

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?

Contact Info

Product

Resources

About