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Neuroborreliosis, also known as Lyme neuroborreliosis (LNB), is a disorder of the

Neuroborreliosis is often preceded by the typical symptoms of Lyme disease, which include erythema migrans and flu-like symptoms such as fever and muscle aches. Neurological symptoms of neuroborreliosis include [[lymphatic meningoradiculitis]], cranial nerve abnormalities, and altered mental status. Sensory findings may also be present. Rarely, a progressive form of encephalomyelitis may occur. In children, symptoms of neuroborreliosis include headache, sleep disturbance, and symptoms associated with increased intracranial pressure, such as papilledema, can occur. Less common childhood symptoms can include meningitis, myelitis, ataxia, and chorea. Ocular Lyme disease has also been reported, as has neuroborreliosis affecting the spinal cord, but neither of these findings are common.^[4]

Diagnosis

A number of diseases can produce symptoms similar to those of neuroborreliosis. They include:

• Alzheimer's disease
• Acute disseminated encephalomyelitis
• Viral meningitis
• Multiple sclerosis
• Bell's palsy^[5]

Neuroborreliosis with symptoms consistent with

Diagnosis is determined by clinical examination of visible symptoms.[7] Neuroborreliosis can also be diagnosed serologically to confirm clinical examination via western blot, ELISA, and PCR.^[8]

Treatment

In the US, neuroborreliosis is typically treated with intravenous antibiotics which cross the blood–brain barrier, such as penicillins, ceftriaxone, or cefotaxime.^[9] One relatively small randomized controlled trial suggested ceftriaxone was more effective than penicillin in the treatment of neuroborreliosis.^[10] Small observational studies suggest ceftriaxone is also effective in children.^[11] The recommended duration of treatment is 14 to 28 days.^[12][13]

Several studies from Europe have suggested oral doxycycline is equally as effective as intravenous ceftriaxone in treating neuroborreliosis. Doxycycline has not been widely studied as a treatment in the US, but antibiotic sensitivities of prevailing European and US isolates of Borrelia burgdorferi tend to be identical. However, doxycycline is generally not prescribed to children due to the risk of bone and tooth damage.^[9]

Discreditied or doubtful treatments for neuroborreliosis include:

• Malariotherapy
• Hyperbaric oxygen therapy
• Colloidal silver
• Injections of hydrogen peroxide and bismacine

Epidemiology

Neuroborrelisosis is caused by the Borrelia burgdorferi bacterium and is a late-stage manifestation of Lyme disease, the most common vector-borne disease in the northeastern hemisphere.^[14] Subsequently, neuroborreliosis is prevalent in areas of high Lyme disease prevalence in North America and Europe.

See also

• Tick-borne disease

References