Diagnosis and management of Lyme neuroborreliosis

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Introduction: The nervous system is involved in 10–15% of patients infected with B. burgdorferi, B. afzelii and B. garinii. This review will address widespread misconceptions about the clinical phenomenology, diagnostic approach and response to treatment of neuroborreliosis. Areas covered: Improvements in diagnostic testing have allowed better definition of the clinical spectrum of neuroborreliosis, with lymphocytic meningitis and uni- or multifocal inflammation of peripheral/cranial nerves predominating. Despite widespread concern that post-treatment cognitive/behavioral symptoms might be attributable to persisting infection or aberrant inflammation within the central nervous system a large body of evidence indicates this is extremely improbable. Importantly, recent studies show most neuroborreliosis can be treated with fairly brief courses of oral antibiotics. All high-level evidence confirms that prolonged courses of antibiotics carry harm with no commensurate benefit. Expert commentary: Lyme disease in the US, and corresponding disorders in Europe, are well defined neuro-infectious diseases that are highly responsive to antibiotic therapy. Although the nervous system is slow to recover after insults (e.g. persistent facial weakness after appropriately treated facial nerve palsy) there is no evidence that prolonged post-treatment neurocognitive symptoms are related to nervous system infection–either as a triggering event or as a cause of ongoing symptoms.

Original languageEnglish (US)
Pages (from-to)5-11
Number of pages7
JournalExpert Review of Anti-Infective Therapy
Volume16
Issue number1
DOIs
StatePublished - Jan 2 2018
Externally publishedYes

Fingerprint

Lyme Neuroborreliosis
Nervous System
Anti-Bacterial Agents
Inflammation
Behavioral Symptoms
Neurobehavioral Manifestations
Lyme Disease
Cranial Nerves
Facial Paralysis
Facial Nerve
Therapeutics
Peripheral Nerves
Meningitis
Communicable Diseases
Central Nervous System
Infection

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this

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Diagnosis and management of Lyme neuroborreliosis. / Halperin, John.

In: Expert Review of Anti-Infective Therapy, Vol. 16, No. 1, 02.01.2018, p. 5-11.

Research output: Contribution to journalReview article

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