Summary
A 42-year-old man suffered from erythema chronicum migrans on different parts of the body after repeated tick bites. A few months after the last tick bite he developed a painful neuropathy in both legs with patchy disturbance of sensibility, mild weakness of the feet and loss of the right ankle jerk. Repeated determinations of antibodies against borrelia spirochetes revealed increasing IgG titres. Biopsy of the left sural nerve, which was clinically and electrophysiologically affected, showed a vasculitis of epineurial vasa nervorum and severe angiopathic lesions of the perineurium and the neural parenchyma. Parenteral high-dose penicillin treatment resolved the clinical symptoms.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ackermann R (1976) Durch Zecken übertragene Meningopolyneuritis. Münch Med Wochenschr 118:1621–1622
Ackermann R (1983) Erythema chronicum migrans und durch Zecken übertragene Meningopolyneuritis (Garin-Boujadoux-Bannwarth): eine Borrelien-Infektion? Dtsch Med Wochenschr 108.15:577–580
Afzelius A (1921) Erythema chronicum migrans. Acta Derm Venereol (Stockh) 2:120
Bannwarth A (1941) Chronische lymphocytäre Meningitis, entzündliche Polyneuritis und Rheumatismus verus. Arch Psychiatr Nervenkr 113:284–376
Bannwarth A (1944) Zur Klinik und Pathogenese der chron. lymphocytären Meningitis. Arch Psychiatr Nervenkr 117:161–185, 682–716
Benach JL, Bosler EM, Haurahan JP (1983) Spirocheta isolated from the blood of two patients with Lyme disease. N Engl J Med 308:740–742
Burgdorfer W, Keiraus JE (1983) Ticks and Lyme disease in the United States. Editorial. Ann Intern Med 99:121–126
Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwaldt E, Davis JP (1982) Lyme disease — a tick borne spirochetosis? Science 216:1317–1319
Caflisch U, Tönz O, Schaad UD, Aeschlimann A, Burgdorfer W (1984) Die Zeckenmeningoradikulitis — eine Spirochetose. Schweiz Med Wochenschr 114:630–634
Garin CH, Boujadoux C (1922) Paralysie par les tiques. J Med Lyon 71:765–767
Hellerström S (1930) Erythema chronicum Afzelius. Acta Derm Venereol (Stockh) 11:315–321
Hörstrup P, Ackermann R (1973) Durch Zecken übertragene Meningopolyneuritis (Garin-Boujadoux-Bannwarth). Neurol Psychiatr 41:583–606
Hollström E (1951) Successful treatment of erythema chronicum Afzelius. Acta Derm Venereol (Stockh) 31:235–240
Pachner RA, Steere AC (1985) The triad of neurologic manifestations of Lyme disease. Neurology (Cleveland) 35:47–53
Pfister HW, Einhäupl K, Preac-Mursic V, Wilske B, Schierz G (1984) The spirochetal etiology of lymphocytic meningoradiculitis of Bannwarth (Bannwarth's syndrome). J Neurol 231:141–144
Reik L, Steere AC, Bartenhagen NH, Shope RE, Malawista SE (1979) Neurologic abnormalities of Lyme disease. Medicine (Baltimore) 58:281–294
Schaltenbrand G (1966) Durch Arthropoden übertragene Erkrankungen der Haut und des Nervensystems. Verh Dtsch Ges Inn Med 72:1557–1562
Schmutzhard E, Stanek G, Pohl P (1985) Polyneuritis cranialis associated with Borrelia burgdorferi. J Neurol Neurosurg Psychiatry 48:1182–1184
Steere AC, Malwista SE, Snydman DR (1977) Lyme arthritis, an epidemic of oligo-arthricular arthritis in children and adults in three Connecticut communities. Arthritis Rheum 20:7–17
Steere AC, Malawista SE, Hardin JA, Ruddy S, Askenase PW, Andiman DA (1977) Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. Ann Intern Med 86:685–698
Steere AC, Malawista SE, Newman JH, Spieler PN, Bartenhagen NH (1980) Antibiotic therapy in Lyme disease. Ann Intern Med 93:1–8
Steere AC, Gradzicki RL, Kornblatt AN, Craft JE, Barbour AG, Burgdorfer W, Schmid GP, Johnson E, Malawista SE (1983) The spirochetal etiology of Lyme disease. N Engl J Med 308:733–740
Steere AC, Pachner AR, Malawista SE (1983) Neurologic abnormalities of Lyme disease. Successful treatment with intravenous high dose penicillin. Ann Intern Med 99:767–772
Vallat JM, Leboutet MJ, Loubet A, Dumas P, Hugon J, Corvisier N (1984) Tick bite neuropathy: an analysis of nerve biopsies from seven cases (abstract). Neurology (Cleveland) 34:180–181
Vital C, Vallat JM (1980) Ultrastructural study of the human diseased peripheral nerve. Masson, New York, pp 114–116
Weber K (1981) Treatment of Lyme diseases (letter). Ann Intern Med 94:137
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Camponovo, F., Meier, C. Neuropathy of vasculitic origin in a case of garin-boujadoux-bannwarth syndrome with positive borrelia antibody response. J Neurol 233, 69–72 (1986). https://doi.org/10.1007/BF00313849
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00313849