The human borreliosis: Lyme neuroborreliosis and relapsing fever

John Halperin, Juan Carlos García-Moncó

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Citation (Scopus)

Abstract

Lyme disease, caused by the tick-borne spirochete Borrelia burgdorferi, infects the nervous system in up to 15% of patients. Involvement can include the peripheral nervous system, with a mononeuropathy multiplex manifest as a radiculopathy, cranial neuropathy, plexopathy, or confluent mononeuropathy multiplex. In most instances, central nervous system involvement is limited to meningitis; rarely the spinal cord or brain parenchyma can be involved. Recent work has shed light on the pathophysiologic sequence that results in neuroborreliosis, including early CNS invasion, CXCL13-stimulated B cell entry into and proliferation within the CNS, and then a prominent immune response that requires ongoing presence of organisms. Pathophysiology of peripheral nerve involvement is not well established although it similarly requires the presence of viable organisms. Future work should focus on the mechanisms of tissue injury. Regardless of the presentation, infection is highly responsive to antimicrobial therapy. Relapsing fever is another human borreliosis caused by a variety of Borrelia species and transmitted by lice (epidemic form) or ticks (endemic form). Both are characterized by recurrent spirochetemia and can cause neurological complications similar to Lyme neuroborreliosis. Diagnosis is made by the direct observation of the spirochetes in peripheral blood during febrile episodes and by PCR. Tetracycline therapy is used.

Original languageEnglish (US)
Title of host publicationCNS Infections
Subtitle of host publicationA Clinical Approach: Second Edition
PublisherSpringer International Publishing
Pages233-269
Number of pages37
ISBN (Electronic)9783319702964
ISBN (Print)9783319702957
DOIs
StatePublished - Jan 17 2018
Externally publishedYes

Fingerprint

Lyme Neuroborreliosis
Relapsing Fever
Mononeuropathies
Spirochaetales
Ticks
Phthiraptera
Borrelia
Cranial Nerve Diseases
Borrelia burgdorferi
Radiculopathy
Lyme Disease
Peripheral Nervous System
Tetracycline
Peripheral Nerves
Meningitis
Nervous System
Spinal Cord
B-Lymphocytes
Fever
Central Nervous System

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Halperin, J., & García-Moncó, J. C. (2018). The human borreliosis: Lyme neuroborreliosis and relapsing fever. In CNS Infections: A Clinical Approach: Second Edition (pp. 233-269). Springer International Publishing. https://doi.org/10.1007/978-3-319-70296-4_11
Halperin, John ; García-Moncó, Juan Carlos. / The human borreliosis : Lyme neuroborreliosis and relapsing fever. CNS Infections: A Clinical Approach: Second Edition. Springer International Publishing, 2018. pp. 233-269
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Halperin, J & García-Moncó, JC 2018, The human borreliosis: Lyme neuroborreliosis and relapsing fever. in CNS Infections: A Clinical Approach: Second Edition. Springer International Publishing, pp. 233-269. https://doi.org/10.1007/978-3-319-70296-4_11

The human borreliosis : Lyme neuroborreliosis and relapsing fever. / Halperin, John; García-Moncó, Juan Carlos.

CNS Infections: A Clinical Approach: Second Edition. Springer International Publishing, 2018. p. 233-269.

Research output: Chapter in Book/Report/Conference proceedingChapter

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Halperin J, García-Moncó JC. The human borreliosis: Lyme neuroborreliosis and relapsing fever. In CNS Infections: A Clinical Approach: Second Edition. Springer International Publishing. 2018. p. 233-269 https://doi.org/10.1007/978-3-319-70296-4_11