The human borreliosis: Lyme neuroborreliosis and relapsing fever

John J. Halperin, Juan Carlos García-Moncó

Research output: Chapter in Book/Report/Conference proceedingChapter

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
PublisherSpringer-Verlag London Ltd
Pages211-226
Number of pages16
ISBN (Electronic)9781447164012
ISBN (Print)1447164008, 9781447164005
DOIs
StatePublished - Mar 1 2014
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. J., & García-Moncó, J. C. (2014). The human borreliosis: Lyme neuroborreliosis and relapsing fever. In CNS Infections: A Clinical Approach (pp. 211-226). Springer-Verlag London Ltd. https://doi.org/10.1007/978-1-4471-6401-2_11
Halperin, John J. ; García-Moncó, Juan Carlos. / The human borreliosis : Lyme neuroborreliosis and relapsing fever. CNS Infections: A Clinical Approach. Springer-Verlag London Ltd, 2014. pp. 211-226
@inbook{8bdcad02059f4e9aa85f40d8a9f56a2e,
title = "The human borreliosis: Lyme neuroborreliosis and relapsing fever",
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.",
author = "Halperin, {John J.} and Garc{\'i}a-Monc{\'o}, {Juan Carlos}",
year = "2014",
month = "3",
day = "1",
doi = "10.1007/978-1-4471-6401-2_11",
language = "English (US)",
isbn = "1447164008",
pages = "211--226",
booktitle = "CNS Infections",
publisher = "Springer-Verlag London Ltd",

}

Halperin, JJ & García-Moncó, JC 2014, The human borreliosis: Lyme neuroborreliosis and relapsing fever. in CNS Infections: A Clinical Approach. Springer-Verlag London Ltd, pp. 211-226. https://doi.org/10.1007/978-1-4471-6401-2_11

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

CNS Infections: A Clinical Approach. Springer-Verlag London Ltd, 2014. p. 211-226.

Research output: Chapter in Book/Report/Conference proceedingChapter

TY - CHAP

T1 - The human borreliosis

T2 - Lyme neuroborreliosis and relapsing fever

AU - Halperin, John J.

AU - García-Moncó, Juan Carlos

PY - 2014/3/1

Y1 - 2014/3/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84934296315&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84934296315&partnerID=8YFLogxK

U2 - 10.1007/978-1-4471-6401-2_11

DO - 10.1007/978-1-4471-6401-2_11

M3 - Chapter

AN - SCOPUS:84934296315

SN - 1447164008

SN - 9781447164005

SP - 211

EP - 226

BT - CNS Infections

PB - Springer-Verlag London Ltd

ER -

Halperin JJ, García-Moncó JC. The human borreliosis: Lyme neuroborreliosis and relapsing fever. In CNS Infections: A Clinical Approach. Springer-Verlag London Ltd. 2014. p. 211-226 https://doi.org/10.1007/978-1-4471-6401-2_11