BACKGROUND: Lyme neuroborreliosis has not been previously reported in Taiwan. The purpose of this study was to describe the important characteristics of Lyme neuroborreliosis caused by Borrelia burgdorferi-like species in Taiwanese patients.
METHODS: Patients with acute neurological symptoms without a clear explanation during September 2005 to December 2008 were enrolled.
All patients received extensive auxiliary investigations, including clinical evaluation by neurological examination, electrophysiological and neuroimaging studies, serological screening tests of serum and cerebrospinal fluid (CSF) by indirect immunofluorescent assay, and Western immunoblot analysis conducted for seroreactivities in serum and CSF of Borrelia burgdorferi-specific IgM and IgG antibodies.
RESULTS: Eleven patients who presented with acute central nervous system (CNS) syndrome fulfilled the diagnostic criteria for neuroborreliosis. In the CSF studies, lymphocytic pleocytosis with elevation of total protein and normal glucose was noted in 9 patients.
The clinical syndromes were confirmed by magnetic resonance imaging and electrophysiological studies.
Ten of 11 patients were found to have brain stem or spinal cord lesions on neuroimaging studies, and 8 patients had concomitant peripheral nervous system involvement with electrophysiological evidence of multiple root lesions with an acute or subacute course.
CONCLUSIONS: Lyme neuroborreliosis presenting as acute CNS syndrome with peripheral nervous system involvement simultaneously in the disease course, especially acute myelopolyradiculitis, in Taiwan is different from Lyme neuroborreliosis seen in Europe and North America. The treatment outcome is variable and based on the severity of initial neurological deficits, early diagnosis, and early management. ----------------- Wow---it sounds like they really understand us. Can't wait to see what they come up with for treatment options....Should be interesting. Unless we are almost dead here we get, " There is nothing wrong with you". And by the time we get somewhere to keep us alive--there is no $$$ for neuroimaging, electrophysiological testing, as well as testing for everything else that may be hidden because of the Lyme... We all may have to hop a boat...
-------------------- Suspected Lyme 07 Test neg One band migrating in IgG region unable to identify.Igenex Jan.09IFA titer 1:40 IND IgM neg pos 31 +++ 34 IND 39 IND 41 IND 83-93 + DX:Neuroborreliosis Posts: 5850 | From Kentucky | Registered: Dec 2008
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