Abstract
The paper deals with nervous manifestations of acute Lyme borreliosis. The authors present the results of investigations made in 77 patients in 1993-1994 who were admitted to hospital and then followed up for six months on account of nervous affections associated with Lyme borreliosis.
The diagnosis of borreliosis was based on the evidence of specific antibodies in serum or cerebrospinal fluid (in 47 patients) or electron microscopic evidence in these media (24 patients). Only six patients had positive antibodies and evidence of borrelia under the electron microscope.
Data on a blood sucking tick in the premorbid stage were reported by two thirds of the patients. Dermal symptoms such as atypical erythemas were reported by 20 patients (26%), typical erythema chronicum migrans only by 6 (8%).
Articular affections such as transient arthralgias or arthritis were found in 8 patients, laboratory signs of cardiac lesions in 6.45 patients (60%) had suffered from acute meningoencephalitis, mostly with a very mild course. 22 (29%) had suffered from acute meningoradiculitis (Bannwarth's syndrome), usually relatively more severe than in the case of acute encephalitis, and it persisted longer (6 patients had detectable neurological affections still after six months). In 10 patients the nervous finding was combined - central and peripheral.
In 290 patients (38%) the neurological finding returned to normal before the patient was discharged from hospital (after 3-5 weeks), 39 (50%) had a residual finding, 9 (12%) severe sequelae. After 6 months 46 patients (60%) recovered completely, 28 partly and 3 had serious sequelae.
In the discussion the authors comment on the most frequent nervous manifestations of neuroborreliosis.