Neurosurgery notes/Infection/Cranial infection/Lyme disease

Lyme disease

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Cranial infection

Cause

  • Borrelia burgdorferi,
    • A tick-borne spirochete

Clinical features

  • A Key Lyme pie to the FACE
    • Facial nerve palsy (typically bilateral)
      • 15% have neurologic symptoms
        • Aseptic meningitis,
        • Cranial neuritis (especially CN VII),
        • Encephalitis,
        • Myelopathy,
        • Radiculopathy, and
        • Peripheral neuropathy.
    • Arthritis
    • Cardiac block
      • Erythema migrans (70%)
      A close-up of a person's arm with a red spot on it AI-generated content may be incorrect.
  • Clinical triad of neurologic manifestations in Lyme disease?
    • Cranial neuritis (mimicking Bell palsy)
    • Meningitis
    • Radiculopathy

Mechanisms

  • Immune complexes and vasculitis with a postviral-type demyelination and perivascular infiltration.

Diagnosis

  • By enzyme-linked immunosorbent assay (ELISA)

Treatment

  • Tetracycline.