Stroke Due to Lyme Neuroborreliosis: Changes in Vessel Wall Contrast Enhancement

Lebas, Axel; Toulgoat, F.; Saliou, Guillaume; Husson, B.; Tardieu, Marc

doi:10.1111/j.1552-6569.2010.00550.x

Cited by 42 publications

(19 citation statements)

References 12 publications

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“…The occurrence of meningeal vasculitis with multiple stenosis of large cerebral arteries with secondary cerebral infarcts in the territories of middle and posterior cerebral arteries, basilar and anterior spinal arteries have been repeatedly reported [52, 53, 76, 85, 89, 102, 104, 105, 107-124]. In a pathologically confirmed case [47, 106] the typical meningovascular alterations of Heubner’s arteritis and chronic meningitis were documented (Fig.…”

Section: Lyme Diseasementioning

confidence: 87%

“…It is also noteworthy, that regressive evolution of cerebral infarct in meningovascular Lyme neuroborreliosis and improvement or disappearance of neuropsychiatric symptoms in Lyme encephalitis following antibiotic treatment were reported by many authors [42, 52, 53, 59, 82, 85, 89, 90, 102, 113-115, 120, 122, 128, 140-142, 158, 159]. …”

Section: Lyme Diseasementioning

confidence: 91%

“…Depressive states among patients with late Lyme disease were reported to be common, ranging from 26-66% [80, 82]. Subacute and slowly progressive dementia both occurs in Lyme disease [48, 68, 81, 94-102]. …”

Section: Lyme Diseasementioning

confidence: 99%

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Chronic or Late Lyme Neuroborreliosis: Analysis of Evidence Compared to Chronic or Late Neurosyphilis

Miklóssy¹

2012

TONEUJ

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Whether spirochetes persist in affected host tissues and cause the late/chronic manifestations of neurosyphilis was the subject of long-lasting debate. Detection of Treponema pallidum in the brains of patients with general paresis established a direct link between persisting infection and tertiary manifestations of neurosyphilis. Today, the same question is in the center of debate with respect to Lyme disease. The goal of this review was to compare the established pathological features of neurosyphilis with those available for Lyme neuroborreliosis. If the main tertiary forms of neurosyphilis also occur in Lyme neuroborreliosis and Borrelia burgdorferi can be detected in brain lesions would indicate that the spirochete is responsible for the neuropsychiatric manifestations of late/chronic Lyme neuroborreliosis. The substantial amounts of data available in the literature show that the major forms of late/chronic Lyme neuroborreliosis (meningovascular and meningoencephalitis) are clinically and pathologically confirmed. Borrelia burgdorferi was detected in association with tertiary brain lesions and cultivated from the affected brain or cerebrospinal fluid. The accumulated data also indicate that Borrelia burgdorferi is able to evade from destruction by the host immune reactions, persist in host tissues and sustain chronic infection and inflammation. These observations represent evidences that Borrelia burgdorferi in an analogous way to Treponema pallidum is responsible for the chronic/late manifestations of Lyme neuroborreliosis.Late Lyme neuroborreliosis is accepted by all existing guidelines in Europe, US and Canada. The terms chronic and late are synonymous and both define tertiary neurosyphilis or tertiary Lyme neuroborreliosis. The use of chronic and late Lyme neuroborreliosis as different entities is inaccurate and can be confusing. Further pathological investigations and the detection of spirochetes in infected tissues and body fluids are strongly needed.

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Section: Lyme Diseasementioning

confidence: 87%

Section: Lyme Diseasementioning

confidence: 91%

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Chronic or Late Lyme Neuroborreliosis: Analysis of Evidence Compared to Chronic or Late Neurosyphilis

Miklóssy¹

2012

TONEUJ

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“…56 Several case reports, exclusively from Europe, have demonstrated cerebral infarction due to vasculitis associ ated with Lyme disease. 46 preceding complaints of headache or recurrent episodes of neurological deficits, as well as those with multiple ischaemic lesions (especially of the posterior circulation), might also have experienced stroke related to Lyme neuroborreliosis. 47,48 Notably, the long-term outcomes of patients with neuroborreliosis-associated stroke seem to be worse than those of typical patients with stroke.…”

Section: Manifestations and Diagnosismentioning

confidence: 97%

“…[46][47][48] In Europe, clinical studies have reported signs of polyneuropathy in 40-60% of patients who present with a pathognomonic late cutaneous manifestation of Lyme disease, acrodermatitis chronica atrophicans (ACA). [49][50][51] The ACA-associated polyneuropathy is asymmetric and predominantly sensory, and usually follows the skin lesion.…”

Section: Manifestations and Diagnosismentioning

confidence: 99%

Lyme neuroborreliosis—epidemiology, diagnosis and management

Fingerle²,

2015

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Lyme disease, caused by the Borrelia burgdorferi bacterium, is the most common vector-borne disease in the northern hemisphere. The clinical presentation varies with disease stage, and neurological manifestations (often referred to as Lyme neuroborreliosis) are reported in up to 12% of patients with Lyme disease. Most aspects of the epidemiology, clinical manifestation and treatment of Lyme neuroborreliosis are well known and accepted; only the management of so-called chronic Lyme disease is surrounded by considerable controversy. This term is used for disparate patient groups, including those who have untreated late-stage infection (for example, late neuroborreliosis), those with subjective symptoms that persist after treatment (termed 'post-treatment Lyme disease syndrome' [PTLDS]), and those with unexplained subjective complaints that may or may not be accompanied by positive test results for B. burgdorferi infection in serum (here called 'chronic Lyme disease'). The incidence of PTLDS is still a matter of debate, and its pathogenesis is unclear, but there is evidence that these patients do not have ongoing B. burgdorferi infection and, thus, do not benefit from additional antibiotic therapy. Chronic Lyme disease lacks an accepted clinical definition, and most patients who receive this diagnosis have other illnesses. Thus, a careful diagnostic work-up is needed to ensure proper treatment.

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Lyme Neuroborreliosis: Clinical Outcomes, Controversy, Pathogenesis, and Polymicrobial Infections

García-Moncó

Benach

2019

Annals of Neurology

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Lyme borreliosis is the object of numerous misconceptions. In this review, we revisit the fundamental manifestations of neuroborreliosis (meningitis, cranial neuritis, and radiculoneuritis), as these have withstood the test of time. We also discuss other manifestations that are less frequent. Stroke, as a manifestation of Lyme neuroborreliosis, is considered in the context of other infections. The summary of the literature regarding clinical outcomes of neuroborreliosis leads to its controversies. We also include new information on pathogenesis and on the polymicrobial nature of tick-borne diseases. In this way, we update the review that we wrote in this journal in 1995.Lyme disease is caused by species of the genus Borrelia (B. burgdorferi, B. garinii, and B. afzelii) (Fig) and is transmitted by ticks of the genus Ixodes. Lyme disease was named for the place where it was first described in the USA, but this disorder was known in Europe for a long time as a dermatological and neurological illness in contrast to the original rheumatological presentation in the USA. The public health burden of tick-borne pathogens continues to grow substantially. 1 The Centers for Disease Control and Prevention (CDC) reports approximately 30,000 cases of Lyme disease per year but estimates that the true incidence is higher. 2 Clinical ManifestationsThe clinical course of Lyme disease is variable and begins with a skin lesion, erythema migrans, several days after a tick bite. Neurological, cardiac, chronic skin, or articular involvement develops later. 3 Neurological impairment can be classified according to the location of the lesion within the neuraxis or to the time course of the disease.

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Stroke Due to Lyme Neuroborreliosis: Changes in Vessel Wall Contrast Enhancement

Cited by 42 publications

References 12 publications

Chronic or Late Lyme Neuroborreliosis: Analysis of Evidence Compared to Chronic or Late Neurosyphilis

Chronic or Late Lyme Neuroborreliosis: Analysis of Evidence Compared to Chronic or Late Neurosyphilis

Lyme neuroborreliosis—epidemiology, diagnosis and management

Lyme Neuroborreliosis: Clinical Outcomes, Controversy, Pathogenesis, and Polymicrobial Infections

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