Neurológia pre prax 4/2021

Lyme neuroborreliosis

Lyme borreliosis is multisystemic disease, caused by a Lyme borrelia from a serocomplex of Borrelia burgdorferi sensu lato. The main vector of borreliae in Europe is Ixodes ricinus. All stages of a tick (larvae, nymphae and adults) play a role in the transmission of the disease. Two borrelial species seem to be the most neurotropic: B. garinii and B. bavariensis. Lyme neuroborreliosis (LNB) is an acute involvement of central and peripheral nervous system which develops usually within a few weeks after a tick-bite. The disease presents as painful meningoradiculoneuritis in adults or as meningoneuritis in children. Cranial neuritis such as unilateral or bilateral facial palsy is the most typical manifestation. Examination of cerebrospinal fluid shows a lymphocytic pleocytosis with evidence of intrathecal production af antibodies to borreliae. Parenteral antibiotic treatment is recommended for LNB.

Keywords: lyme neuroborreliosis, borrelia burgdorferi, facial palsy, intrathecal synthesis