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NEUROBORRELIOSIS
By/ Mohammed Al-Rweely & Abdullatiff Al-
Rashed
Definition
 Lyme neuroborreliosis (LNB) is an infectious
disorder of the nervous system caused by tick-
borne spirochetes...
Etiology
Caused by tick-borne
spirochete Borrelia
burgdorferi sensu lato .
Its passage through the
Blood-Brain-Barrier
r...
Epidemiology
 Lyme Disease (LD) is the most frequently
reported tick-related infection in the western
hemisphere with mos...
Signs and Symptoms
 Erythema Migrans (EM)
Rash.
 Flu-like illness
 Headache
 Extreme Fatigue
 TMJ/ Jaw Pain
(Temporom...
Cont.
 LNB connections to neuropsychological
conditions include:
 Panic attacks and Anxiety
 Depression
 Schizophrenia
Diagnosis
-Specific IgG/IgM antibodies in serum and CSF.
-CSF R/E (increased cells and protein
concentration)
-Positive bo...
Diagnosis
 Bb-specific antibodies in serum and CSF
Bb-specific antibodies in serum can be
detected with an IgG- and IgM-d...
Differential diagnosis
 Alzheimer's disease
 Acute disseminated encephalomyelitis
 Viral meningitis
 Multiple sclerosi...
Differential diagnosis
Treatment
 Oral Doxycycline: is a relatively new antibiotic
used in LNB treatment. Is administered orally for
peripheral ...
References
 EFNS guidelines on the diagnosis and
management of European Lyme
Neuroborreliosis.
 Neuroborreliosis: pathog...
Neuroborreliosis
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Neuroborreliosis

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Neuroborreliosis

  1. 1. NEUROBORRELIOSIS By/ Mohammed Al-Rweely & Abdullatiff Al- Rashed
  2. 2. Definition  Lyme neuroborreliosis (LNB) is an infectious disorder of the nervous system caused by tick- borne spirochetes of the Borrelia burgdorferi (Bb) sensu lato complex
  3. 3. Etiology Caused by tick-borne spirochete Borrelia burgdorferi sensu lato . Its passage through the Blood-Brain-Barrier results in Central Nervous System (CNS) infection, causing widespread neurological symptoms
  4. 4. Epidemiology  Lyme Disease (LD) is the most frequently reported tick-related infection in the western hemisphere with most cases being present throughout Canada and the USA.  Borrelia burgdorferi infected ticks are present globally, but seem to be endemic to specific regions throughout Canada and USA.
  5. 5. Signs and Symptoms  Erythema Migrans (EM) Rash.  Flu-like illness  Headache  Extreme Fatigue  TMJ/ Jaw Pain (Temporomandibular Join)  Neck & Back Pain  Joint Pain & Swelling, Bone Pain (EM) Rash
  6. 6. Cont.  LNB connections to neuropsychological conditions include:  Panic attacks and Anxiety  Depression  Schizophrenia
  7. 7. Diagnosis -Specific IgG/IgM antibodies in serum and CSF. -CSF R/E (increased cells and protein concentration) -Positive borrelia titre.
  8. 8. Diagnosis  Bb-specific antibodies in serum and CSF Bb-specific antibodies in serum can be detected with an IgG- and IgM-differentiating enzyme-linked immunosorbent assay (ELISA)  CXCL13 appears to be a promising marker for the diagnosis of early cases with negative antibody index, for activity of disease and as a therapy marker. CXCL13 has been found in high levels in the CSF in acute, untreated LNB.
  9. 9. Differential diagnosis  Alzheimer's disease  Acute disseminated encephalomyelitis  Viral meningitis  Multiple sclerosis  Bells palsy.
  10. 10. Differential diagnosis
  11. 11. Treatment  Oral Doxycycline: is a relatively new antibiotic used in LNB treatment. Is administered orally for peripheral infections during LD, but both oral and intravenous administration during LNB have proven effective.  Ceftriaxone & Cefotaxime : Ceftriaxone is currently the drug of choice for LNB treatment and is administered intravenously.  Amoxicillin : for eraly presentation of LD in children, but has been shown to successfully treat 7th nerve palsy  Penicillin : least effective.
  12. 12. References  EFNS guidelines on the diagnosis and management of European Lyme Neuroborreliosis.  Neuroborreliosis: pathogenesis, symptoms, diagnosis and treatment,Tobias A Rupprecht​†1 & Volker Fingerle​2 , 2011.  http://neurowiki2012.wikispaces.com/Lyme+Di sease+and+Neuroborreliosis#6.1  http://www.lymediseaseassociation.org/index.p hp/about-lyme/medical/symptom-list

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