I have several abstracts on file about back pain that was caused by Lyme Disease.-----------
Title: Neuro-borreliosis or intervertebral disk prolapse?
Authors: Dieterle L, Kubina FG, Staudacher T, B:udingen HJ
Source: Dtsch Med Wochenschr 1989 Oct 20;114(42):1602-6
Organization: Abteilung f:ur Neurologie und klinische Neurophysiologie, St.-Elisabethen-Krankenhaus Ravensburg.
Abstract:
Between September 1986 and November 1988, 17 patients were hospitalized and treated for neuro-borreliosis.
Ten of them had been admitted with suspected lumbar or cervical root or compression syndrome.
Only four patients recalled a tick bite, only three an erythema migrans.
Uni- or bilateral facial paresis was a prominent feature in six patients.
Three of 14 patients had no IgG antibodies against Borrelia, either in serum or cerebrospinal fluid at the initial examination, two had positive titres in serum only.
Despite antibiotic treatment (usually 10 mega U penicillin three times daily) six patients had a recurrence by April, 1989, treated with penicillin again or with twice daily 100 mg doxycycline or 2 g ceftriaxon.
In four of them a residual painful polyneuropathy remains.
Language: Ger
Unique ID: 90032324
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From: Neurologic Manifestations of Lyme Disease, the New "Great Imitator"
Author: Andrew Pachner
Source: Review of Infectious Diseases Vol. 11, supplement 6 Sept-Oct 1989
"A washington D.C. business executive had developed pain in both his shoulders and arms.
The pain described as aching or gnawing and sometimes electrical, was worse on the left side.
A diagnosis of cervical disk disease was made., and a number of remedies appropriate for such a diagnosis were attempted. None was sucessful.
Subsequent computed tomography and magnetic resonance imaging of the cervical spine revealed a small right C5 disk.
The patient's discomfort was attributed to this disk despite the fact that he had bilateral symptoms that were more severe on the contralateral.......serologic studies for Lyme disease were performed.
The result was positive....A positive Lyme serology was confirmed in my lab...therapy with intravenous penicillin ..was begun. The patient has done well, with resolution of his pain and no progression of his disease...."
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Meningoradiculoneuritis mimicking vertebral disc herniation. A "neurosurgical" complication of Lyme-borreliosis.
Authors: Meier C, Reulen HJ, Huber P, Mumenthaler M
Source: Acta Neurochir (Wien) 1989;98(1-2):42-6
Organization: University Department of Neurology, Inselspital, Bern, Switzerland.
Abstract:
We report on 3 patients with meningoradiculoneuritis (MRN) due to Lyme-borreliosis (LB), which presented clinically as vertebral disc herniation.
In 2 cases the underlying infection was discovered only after unsuccessful neurosurgical treatment.
In the differential diagnosis between MRN and disc herniation the following criteria are suggestive of MRN and should raise suspicion of a non-discogenic aetiology:
History of tick bite or erythema chronicum migrans,
fever or general malaise,
mono- or oligoradiculopathy with absent or insignificant lumbar pain
and complaints of a burning character of the radiating pain.
In suspicious cases we recommend blood investigations including antibody determination against borrelia burgdorferi and CSF investigations including cell count and cytology, protein and glucose determination, nephelometry and isoelectric focusing to exclude MRN and other conditions that may mimic disc herniation.
Language: Eng
Unique ID: 89300369
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Title: Meningopapillitis disclosing Lyme disease
Authors: Gerard P, Canaple S, Rosa A
Source: Rev Neurol (Paris) 1996 Jun-Jul;152(6-7):476-8
Organization: Service de Neurologie, CHU Amiens.
Abstract:
A 65 old year woman was admitted to the hospital for a low back pain, a fever and an elevated sedimentation rate.
Four months later she noted a progressive visual loss first affected the right eye (visual acuity: 6/10) and then the left (visual acuity : 6/10).
Fundus examination showed a bilateral papilledema. CT Scan and MRI were normal.
A lumbar puncture disclosed a lymphocytic pleocytosis (68 leukocytes/mm3), an increase in protein level (1,9 g/l) and oligoclonal bands.
A serologic test for B. Burgdorferi was positive both in blood (1/64 degrees) and n cerebrospinal fluid (> or = 1/128).
The patient was treated with intravenous ceftriaxone 2 g daily for 2 weeks.
Fifteen days later the low back pain had disappeared and the CSF cellular count had decreased to 20 leukocytes/mm3.
Seven months later, CSF was normal (2 leukocytes/mm3, protein level: 0.65 g/l.);
Titer against B. Burgdorferi had improved to 1/160 in serum and 1/16 in CSF;
visual acuity had improved to 8/10 on left, and was the same on right.
Language: Fre
Unique ID: 97099678
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Title: Persistent leg pain (clinical conference)
Authors: Satz N, Dvorak J, Reich C, Knoblauch M
Source: Schweiz Rundsch Med Prax 1990 Jul 3;79(27-28):886-8
Organization: Medizinische Abteilung Kreisspital M:annedorf, Z:urich.
Abstract:
A 72 year old patient suddenly experienced severe lumbar pain irradiating into the right leg.
Later on, weakness of the muscles thigh appeared.
A thorough radiological investigation which showed degenerative alterations of the vertebral column did not supply an explanation.
After a pathological titer against Borrelia burgdorferi was found in serum and radiculitis was detected on EMG, the diagnosis of Lyme-Borreliosis of the nervous system could be confirmed by analysis of the cerebrospinal fluid.
Under intravenous antibiotic treatment with Ceftriaxone (2 to 4 g daily for three weeks) the symptoms regressed completely, and the pathological findings in the CSF regressed. The significance of some findings in CSF in relation to Borreliosis of the CNS.
Language: Ger
Unique ID: 90326934
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Source: Brain (1992), 115, 399-423
Title: The Clinical and Epidemiological Profile of Lyme Neuroborreliosis in Denmark 1985-1990
Authors: Klaus Hansen and Anne-Mette Lebech
Painful sensory radiculitis
Radiculitic pain was a major symptom and present in 160 patients (86%), beginnning 5--90 days (median 19 days) after the erythema migrans. T
he intensity of radicular pain increased significantly with the age of the individual. The onset was in most instances subacute, occuring overnight.
Pain often began in the region of a previous erythema migrans, then migrated and finally became most pronounced axially in the back typically between the shoulder blades but also in the neck or lumbar region.
Some patients had migrating pain almost over the whole body. The pain was described as being of a type never experienced before and was easily distinguished from ordinary back pains.
The intensity of the pain often varied from day to day and typically showed severe nocturnal exacerbations(n=68).
Pain was described by most patients as severe, burning, deep and/or superficial as if located in the skin, and often accompanied by patchy areas of unpleasant hyper- and dysaesthesiae (n=63).
Occasionally a belt-like sensation around the trunk was described.
Severe pain was refractory to morphine.
46 patients had radiculitic pain only and never developed focal motor sign.
Before the final diagnosis of neuroborreliosis was established, the painful condition was often thought due to other disease, e.g. herpes-zoster neuralgia, cervical or lumbar nerve root compression, facet syndrome, brachial plexus neuropathy, polymyalgia rheumatica, myocardial infarction or kidney concrements.
In one female a cholecystectomy (gallbladder removal) was performed, three patients underwent a biopsy of the temporal artery, three an iv pyelogram, seven bone scintigraphy and 17 a myelogram, before the final diagnosis.
Some patients presented with an agitated mental state....Thirteen patients were intially suspected of being hysterical and several were examined by a psychiatrist because of the apparent disproportion between their dramatic complaints and the lack of signs of disease.
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