Neuroborreliose

Neuroborreliosis: symptoms and course

Physicians distinguish between acute and chronic neuroborreliosis. The latter is said to last for more than six months.

Acute neuroborreliosis: symptoms

Neuroborreliosis is acute in 90 to 95 percent of all cases: The first symptoms occur within weeks to months after the tick bite, in which the bacterium Borrelia burgdorferi was transmitted. The sufferers develop one non-purulent inflammation of the meninges and nerve roots of the spinal cord. Doctors here speak of meningopolyradiculitis. She can be agonizing Pain in the area of ​​the nerve roots and nerve pathways, which are noticeable especially at night.

It may too too paresthesia and paralysis come. Especially on the face, a one- or two-sided paralysis may occur (facial paralysis). Then the 7th cranial nerve (facial nerve or facial nerve) is affected by the inflammation. Other cranial nerves can also become infected, resulting in, for example, paralysis of the eye muscles or hearing loss.

Acute neuroborreliosis lasts less than six months.

Chronic neuroborreliosis

In five to ten percent of neuroborreliosis patients, the neurological symptoms develop slowly over months to years. Typically, it comes to a chronically progressive Inflammation of the brain and spinal cord (Encephalomyelitis). Although those affected usually have no pain, they suffer from gait and movement disorders as well as problems during bladder emptying.

Other possible neuroborreliosis symptoms at this stage include speech and speech disorders, hearing loss, and coordination disorders. In chronic neuroborreliosis, epilepsy or organic psychosyndrome (with impaired concentration and consciousness as well as hallucinations) rarely develop. Also rare are blood vessels in the brain, which can lead to a stroke.

Post-Lyme Disease Syndrome

In addition to chronic neuroborreliosis, unspecific chronic conditions such as persistent fatigue, listlessness, and lack of concentration in the media are often associated with a history of Lyme disease infection when Borrelia antibodies are found in the patient’s blood. One speaks then of the so-called “Post-Lyme Disease syndromes“sometimes”chronic fatigue“or”Fibromyalgia-like complaintsHowever, such chronic conditions are not typical Lyme disease or neuroborreliosis symptoms, so it’s important to first think about other conditions, such as another chronic infection, autoimmune disease or depression.

Neuroborreliosis: examination and diagnosis

If a patient above symptoms and from a past tick bite reported, the doctor is suspected of neuroborreliosis. This also applies if a patient does not remember a tick bite, but the possibility existed or exists (through walks in the forest, gardening, etc.).

laboratory tests

To clarify the suspicion, the doctor can perform various laboratory tests. It can adjust the blood and cerebrospinal fluid (CSF) of the patient for specific antibody to test for Borrelia bacteria. However, the results of such tests can not always be interpreted clearly. One of the reasons for this is that many healthy people also carry Borrelia antibodies without any other evidence of acute or chronic Lyme disease.

In addition to Borrelia antibodies, the cerebrospinal fluid sample can provide further evidence of (possible) neuroborreliosis: an increased number of white blood cells (Leukocytes). But this can also have other causes.

There is also the possibility of the pathogen yourself or be heritage in cerebrospinal fluid. But this is not possible in all cases.

Further investigations

In individual cases the doctor can carry out further examinations. For example, brain and spinal cord inflammation may require an MRI scan of the skull and spine. The doctor can also check the speed of signal transmission of various nerves (electroneurography). Sometimes it also makes sense to test the electrical activity of muscles (electromyography).

Neuroborreliosis: therapy

The Neuroborreliose is (like the normal Borreliose) with antibiotics treated. In acute neuroborreliosis doctors often prescribe tablets with the active ingredient doxycycline. In some cases, antibiotics are also administered directly into a vein (intravenously), for example the active ingredient ceftriaxone. The antibiotic therapy is usually performed for two weeks.

Even in chronic neuroborreliosis antibiotics are usually given intravenously. The recommended duration of treatment is two to three weeks. An even longer antibiotic therapy is discouraged because there is no evidence that it helps better than a two- to three-week treatment. In addition, long-term antibiotic therapy can have serious side effects.

For patients who still have symptoms six months after the antibiotic therapy, a sample of cerebrospinal fluid should be taken and examined again. If the number of white blood cells is still elevated, the antibiotic NeuroborrelioseTherapy be repeated.