This is topic "Fatal course of cerebral vasculitis induced by neuroborreliosis in forum Medical Questions at LymeNet Flash.


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Posted by Pinelady (Member # 18524) on :
 
http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2010;volume=58;issue=1;spage=139;epage=141;aulast=Buchwald

[ 04-05-2010, 04:15 PM: Message edited by: Pinelady ]
 
Posted by Keebler (Member # 12673) on :
 
-
Pinelady, thanks for this (sad) link. It sparked an interest and I've outlined it with some added thoughts below.

===============

Fatal course of cerebral vasculitis induced by neuroborreliosis.

Neurol India 2010;58:139-41

Excerpts:

May 2008 . . . a 25-year-old male

. . . possibility of neuroborreliosis was excluded. He was put on aspirin 160 mg once a day and dipyridamole 200 mg twice a day. His state continued to improve and one week later he was discharged. . . .

. . . About five weeks after discharge, his condition slowly worsened. His original symptoms progressed in severity and, in addition, he developed dysphasia and paresis of his left leg. . . .

These findings were strongly suggestive of neuroborreliosis. . . .

. . . He was treated with oral doxycycline 200 mg twice daily for 12 days.

His vasculitis was initially treated with IV methylprednisolone 1 g for three consecutive days followed by oral prednisone 60 mg per day. In spite of this treatment, his state continued to deteriorate. . . .

. . . He returned to our emergency room about 3 weeks later . . . consistent with cerebral vasculitis . . .

. . . patient delayed institution of appropriate specific treatment might have resulted in the fatal outcome. A contributing factor was failure on the part of the patient by not calling on us in spite of three weeks of deterioration. . . .

-Full letter at link above.
=========================

Note for reference: Steroids such as methylprednisolone and prednisone should never be given to lyme patients without adequate prior use of specific antibiotics at specific levels. ILADS-trained doctors would have known this.

oral doxycycline - 200 mg twice daily for 12 days is not enough to treat lyme. But, the IDSA guidelines seem to have traveled the globe.

As well, there is repeated mention of the use of spinal taps for this patient. That is really unnecessary when looking for lyme, it can impede diagnosis and put the patient in far more pain - and debt.

These doctors followed IDSA, no doubt about that. Had they been knowledgeable of ILADS' research, the outcome might have been very different, indeed.

But they probably have never been exposed to the real research such as with ILADS' authors and they likely (yet erroneously) thought the IDSA was on top of lyme.

So, do we still want to stick with doctors who stick to the IDSA guidelines?
-
 
Posted by Pinelady (Member # 18524) on :
 
No Keebler we don't, and people across the globe should not either.

Not to mention all those poor souls who have been diagnosed with the syndrome of MS.

The steroids could have helped send this patient over the edge.
 
Posted by Pinelady (Member # 18524) on :
 
So does some of the responsibility lie with the

doctors who like us have a chance to change?

Or is it across the board things need changed?
 
Posted by nenet (Member # 13174) on :
 
This is a very important case study - I'm bumping for others to have a chance to see it.


Thank you very much Pinelady for posting it. Could you possibly add "neuro-Lyme" or "neuroborreliosis" and "vasculitis" to the title, or maybe the full title of the case study "Fatal course of cerebral vasculitis induced by neuroborreliosis"?


It would help others find the topic when they are looking for information about vasculitis and Lyme. This was one of my Lyme symptoms, and I was actually diagnosed with cerebral vasculitis. Thanks to antibiotics, this symptom has gone away.


For anyone who has feelings of pain in their head that increases with startling or stress, or any feelings of tightness, soreness, burning, or pressure, these are just a few of the symptoms that can indicate vasculitis. Please get it checked out immediately, and get proper ILADS Guidelines Lyme treatment ASAP.
 
Posted by nenet (Member # 13174) on :
 
Here is a sample of many related articles from Pubmed:

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Link&LinkName=pubmed_pubmed&from_uid=20228487


1. Fatal course of cerebral vasculitis induced by neuroborreliosis.

Buchwald F, Abul-Kasim K, Tham J, Hansen BU.

Neurol India. 2010 Jan-Feb;58(1):139-41. No abstract available. PMID: 20228487 [PubMed - in process]Related articlesFree article


2. [Neuroborreliosis with extensive cerebral vasculitis and multiple cerebral infarcts]

Schmitt AB, K�ker W, Nacimiento W.

Nervenarzt. 1999 Feb;70(2):167-71. German. PMID: 10098153 [PubMed - indexed for MEDLINE]Related articles


3. [Vasculitis course of neuroborreliosis with thalamic infarct]

Keil R, Baron R, Kaiser R, Deuschl G.

Nervenarzt. 1997 Apr;68(4):339-41. German. PMID: 9273464 [PubMed - indexed for MEDLINE]Related articles


4. Cerebral vasculitis and stroke in Lyme neuroborreliosis. Two case reports and review of current knowledge.

Topakian R, Stieglbauer K, Nussbaumer K, Aichner FT.

Cerebrovasc Dis. 2008;26(5):455-61. Epub 2008 Sep 23. Review.PMID: 18810231 [PubMed - indexed for MEDLINE]Related articles

...

6. Stroke in neuroborreliosis.

May EF, Jabbari B.

Stroke. 1990 Aug;21(8):1232-5. Review.PMID: 2202096 [PubMed - indexed for MEDLINE]Related articlesFree article


7. Unexplained cerebral vasculitis and stroke: keep Lyme neuroborreliosis in mind.

Topakian R, Stieglbauer K, Aichner FT.

Lancet Neurol. 2007 Sep;6(9):756-7; author reply 757. No abstract available. PMID: 17706557 [PubMed - indexed for MEDLINE]Related articles


8. [Neuroborreliosis: progressive encephalomyelitis with cerebral vasculitis]

Lock G, Berger G, Gr�be H.

Monatsschr Kinderheilkd. 1989 Feb;137(2):101-4. German. PMID: 2716736 [PubMed - indexed for MEDLINE]Related articles


9. Subarachnoid hemorrhage due to Borrelia burgdorferi-associated vasculitis.

Jacobi C, Schwark C, Kress B, Hug A, Storch-Hagenlocher B, Schwaninger M.

Eur J Neurol. 2006 May;13(5):536-8.PMID: 16722982 [PubMed - indexed for MEDLINE]Related articles


10. Intracerebral haemorrhage as a manifestation of Lyme neuroborreliosis?

Scheid R, Hund-Georgiadis M, von Cramon DY.

Eur J Neurol. 2003 Jan;10(1):99-101. Review.PMID: 12535004 [PubMed - indexed for MEDLINE]Related articles


...


12. Neuroborreliosis causing focal cerebral arteriopathy in a child.

Cox MG, Wolfs TF, Lo TH, Kappelle LJ, Braun KP.

Neuropediatrics. 2005 Apr;36(2):104-7.PMID: 15822023 [PubMed - indexed for MEDLINE]Related articles


13. Primarily chronic and cerebrovascular course of Lyme neuroborreliosis: case reports and literature review.

Wilke M, Eiffert H, Christen HJ, Hanefeld F.

Arch Dis Child. 2000 Jul;83(1):67-71. Review.PMID: 10869004 [PubMed - indexed for MEDLINE]Related articlesFree article


...


15. Neuroborreliosis with vasculitis causing stroke-like manifestations.

Romi F, Kr�kenes J, Aarli JA, Tysnes OB.

Eur Neurol. 2004;51(1):49-50. Epub 2003 Nov 21. No abstract available. PMID: 14639033 [PubMed - indexed for MEDLINE]Related articles


...


17. Cerebral vasculitis with multiple infarcts caused by lyme disease.

Schmiedel J, Gahn G, von Kummer R, Reichmann H.

Cerebrovasc Dis. 2004;17(1):79-81. Epub 2003 Oct 6. No abstract available. PMID: 14534380 [PubMed - indexed for MEDLINE]Related articles
 


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