Doença de lyme com envolvimento neurológico:  um desafio diagnóstico / Lyme disease with neurological involvement: A diagnostic challenge

Neurological involvement in Lyme disease has been reported to include meningitis, cranial neuropathy and radiculoneuritis. While it is known that in some cases of asceptic meningitis patients may develop hyperosmia, the association between hyperosmia and Lyme disease has not previously been studied. Objective To carry out the first systematic study to ascertain whether hyperosmia is also a feature of Lyme disease. Method A questionnaire regarding abnormal sensory sensitivity in respect of the sense of smell was administered to 16 serologically positive Lyme disease patients and to 18 control subjects. Results The two groups were matched in respect of age, sex and body mass. None of the 34 subjects was suffering from migraine. Eight (50%) of the Lyme patients and none (0%) of the controls suffered from hyperosmia (p=0.0007). Conclusion This first systematic controlled study showed that Lyme disease is associated with hyperosmia.

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LYME BORRELIOSIS: CLINICAL MANIFESTATIONS AND ADVANCES IN DIAGNOSIS AND CONTROL

Journal of Experimental Biology and Agricultural Sciences ◽

10.18006/2020.8(6).721.729 ◽

2020 ◽

Vol 8 (6) ◽

pp. 721-729

Author(s):

Sandip Kumar Khurana ◽

◽

Anju Sehrawat ◽

Ruchi Tiwari ◽

Khan Sharun ◽

...

Keyword(s):

Lyme Disease ◽

Early Stage ◽

Erythema Migrans ◽

Clinical Manifestations ◽

Neurological Involvement ◽

Vector Borne Diseases ◽

Clinical Syndromes ◽

Clinical Presentations ◽

Vector Borne ◽

And Control

Lyme disease or borreliosis is presumed one of the most significant vector-borne diseases globally. The disease is re-emerging in numerous parts of world. It has expanded dramatically in newer areas in recent decades. Lyme disease is caused by Borrelia burgdorferi yet additionally by other borrelial species, B. afzelii and B. garini which cause diverse clinical syndromes. Spatial distribution and clinical presentations differ depending on the causative species. Clinical manifestations of Lyme disease can be delineated in three stages. The first stage is presented in the form of erythema migrans at the site of tick bite. Early dispersed stage can lead to multiple lesions of erythema migrans, neuroborreliosis, lymphocytoma, arthritis or carditis. The manifestation at later stage shows acordermatitis chronica atrophicans, arthritis and neurological involvement. Diagnosis is challenging owing the several clinical presentations and could require multiple tests. The antibiotics that are currently under use, help in the clearance of bacteria from the affected host and stop further spread of the disease. Although several antibiotics are being used for Lyme disease, doxycycline is the widely used antimicrobial in early stage of the disease. Several attempts have been made to develop a vaccine against Lyme disease, however, none of them have been successfully marketed. The present review discusses clinical manifestations, and advances in diagnosis and control of Lyme disease.

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Hydrocephalus as the first presenting symptom of neurosarcoidosis in two patients: a diagnosis more forthcoming in the context of systemic disease

BMJ Case Reports ◽

10.1136/bcr-2019-229903 ◽

2019 ◽

Vol 12 (8) ◽

pp. e229903 ◽

Cited By ~ 2

Author(s):

Anna McKeever ◽

Amanda Cox ◽

Matthew Garnett ◽

Nicholas G Cunniffe

Keyword(s):

Physical Disability ◽

Systemic Disease ◽

Clinical Manifestations ◽

Neurological Involvement ◽

High Morbidity ◽

Diagnostic Challenge ◽

Multisystem Disorder ◽

Central Nervous System Inflammation ◽

Surgical Interventions ◽

Granulomatous Diseases

Sarcoidosis is a multisystem disorder, characterised histologically by the presence of non-caseating epithelioid granulomas with exclusion of other granulomatous diseases. While the lungs and lymph nodes are affected in 90%, approximately 5% of patients have neurological involvement. The clinical manifestations of neurosarcoidosis (NS) are diverse, making diagnosis especially difficult in patients without known systemic disease. Hydrocephalus occurs in only 9% of patients with NS and although uncommon, is an important manifestation because it is associated with high morbidity and mortality. We report two cases of NS presenting with hydrocephalus, one as the first presentation of sarcoidosis and one in a patient with known multisystem sarcoidosis. The patient without systemic sarcoidosis posed the greater diagnostic challenge and followed a protracted course with multiple surgical interventions, progression of central nervous system inflammation and significant physical disability.

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Cranial nerve palsies, SIADH and atrial fibrillation: a diagnostic challenge

BMJ Case Reports ◽

10.1136/bcr-2021-244807 ◽

2021 ◽

Vol 14 (9) ◽

pp. e244807

Author(s):

Rahul Karna ◽

Bandhul Hans ◽

Julie Murone ◽

John Black

Keyword(s):

Atrial Fibrillation ◽

Lyme Disease ◽

Cranial Nerve ◽

Hormone Secretion ◽

Type Ii ◽

Diagnostic Challenge ◽

Predisposing Factor ◽

Inappropriate Antidiuretic Hormone Secretion ◽

Cranial Nerve Palsies ◽

Ventricular Response

We recently encountered a 79-year-old Caucasian man who presented with blurring of vision and facial muscle weakness. The patient also had hyponatraemia, atrial fibrillation with rapid ventricular response and underlying Brugada type II pattern. Urine and serum osmolality were consistent with syndrome of inappropriate antidiuretic hormone secretion (SIADH). It was only after extensive imaging and workup that we were able to tie together these three different presentations of Lyme disease—cranial nerve palsies, SIADH and atrial fibrillation and treat them accordingly. To the best of our knowledge, only eight cases of SIADH in patients with Lyme neuroborreliosis have been reported in the literature. Although our patient did not have a history of arrhythmias, case findings suggest that underlying Brugada type II morphology could have been the predisposing factor, and Lyme disease the trigger.

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New ultrastructural findings about Borrelia burgdorferi by cryofixation, negative staining, thin sectioning and scanning techniques

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100160467 ◽

1990 ◽

Vol 48 (3) ◽

pp. 582-583

Author(s):

S. F. Hayes ◽

M. D. Corwin ◽

T. G. Schwan ◽

D. W. Dorward ◽

W. Burgdorfer

Keyword(s):

Lyme Disease ◽

Borrelia Burgdorferi ◽

Structural Characterization ◽

Negative Staining ◽

Low Speed ◽

Thin Sectioning ◽

Ultrastructural Findings

Characterization of Borrelia burgdorferi strains by means of negative staining EM has become an integral part of many studies related to the biology of the Lyme disease organism. However, relying solely upon negative staining to compare new isolates with prototype B31 or other borreliae is often unsatisfactory. To obtain more satisfactory results, we have relied upon a correlative approach encompassing a variety EM techniques, i.e., scanning for topographical features and cryotomy, negative staining and thin sectioning to provide a more complete structural characterization of B. burgdorferi.For characterization, isolates of B. burgdorferi were cultured in BSK II media from which they were removed by low speed centrifugation. The sedimented borrelia were carefully resuspended in stabilizing buffer so as to preserve their features for scanning and negative staining. Alternatively, others were prepared for conventional thin sectioning and for cryotomy using modified procedures. For thin sectioning, the fixative described by Ito, et al.

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