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Verlauf der akuten und chronischen Neuroborreliose nach Behandlung mit Ceftriaxon

Clinical courses of acute and chronic neuroborreliosis following treatment with ceftriaxone

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Zusammenfassung

Zwischen 1990 und 2000 wurden insgesamt 101 Patienten mit einer klinisch und liquordiagnostisch (Pleozytose, erhöhter borrelienspezifischer Antikörper-Index) gesicherten akuten (N=86) bzw. chronischen (N=15) Neuroborreliose über jeweils 2 bzw. 3 Wochen mit 2 g Ceftriaxon i.v. pro Tag behandelt. Die Patienten wurden nach 3, 6 und 12 Monaten klinisch und serologisch nachuntersucht. Nach 6 Monaten war die Erkrankung bei 93% der Patienten mit akuter und bei 20% der Patienten mit chronischer Neuroborreliose ausgeheilt. Nach einem Jahr betrug die Heilungsrate bei der akuten Neuroborreliose 95% und bei der chronischen Neuroborreliose 66%: Bei 4 Patienten mit akuter Neuroborreliose bestanden noch leichte Fazialisinnervationsstörungen, bei 5 Patienten mit chronischer Neuroborreliose noch Störungen der Motorik und Koordination. Fazit: Die Häufigkeit residualer Symptome bei der akuten Neuroborreliose entspricht der Spontanprognose idiopathischer Fazialisparesen, die Prognose der chronischen Neuroborreliose ist meist ungünstiger und korreliert mit der Dauer der Symptomatik bis zur Diagnosestellung.

Summary

Between 1990 and 2000, a total of 101 patients with acute (n=86) or chronic (n=15) neuroborreliosis (proven by clinical data, pleocytosis in the CSF, and elevated Borrelia burgdorferi-specific antibody indices) were treated with 2 g of ceftriaxone per day for either 2 or 3 weeks. The patients were reexamined clinically and serologically after 3, 6, and 12 months. Six (12) months after the antibiotic treatment, about 93% (95%) of the patients with acute neuroborreliosis and 20% (66%) of the patients with chronic neuroborreliosis were cured. One year after treatment, four patients with acute neuroborreliosis still suffered from facial palsy and five with chronic neuroborreliosis still had moderate spastic ataxic gait disturbance. The prognosis of facial palsy in neuroborreliosis is quite similar to that in idiopathic facial palsy, while that in chronic neuroborreliosis largely depends on the time elapsed before diagnosis.

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Literatur

  1. Aberer E, Breier F, Stanek G, Schmidt B (1996) Success and failure in the treatment of acrodermatitis chronica atrophicans. Infection 24:85–87

    CAS  PubMed  Google Scholar 

  2. Dattwyler RJ, Halperin JJ, Pass H, Luft BJ (1987) Ceftriaxone as effective therapy in refractory Lyme disease. J Infect Dis 155:1322–1325

    CAS  PubMed  Google Scholar 

  3. Dotevall L, Hagberg L (1999) Successful oral doxycycline treatment of Lyme disease-associated facial palsy and meningitis. Clin Infect Dis 28:569–574

    CAS  PubMed  Google Scholar 

  4. Engelter S, Lyrer P, Radu EW, Steck AJ (1996) Acute infectious disorders of the spinal cord and its roots with gadolinium-DTPA enhancement in magnetic resonance imaging. J Neurol 243:191–195

    CAS  PubMed  Google Scholar 

  5. Hammers-Berggren S, Hansen K, Lebech AM, Karlsson M (1993) Borrelia burgdorferi-specific intrathecal antibody production in neuroborreliosis: a follow-up study. Neurology 43:169–175

    CAS  PubMed  Google Scholar 

  6. Hammers-Berggren S, Lebech A M, Karlsson M, Svenungsson B, Hansen K, Stiernstedt G.1994.Serological follow-up after treatment of patients with erythema migrans and neuroborreliosis. J Clin Microbiol 32:1519–1525

    CAS  PubMed  Google Scholar 

  7. Hansen K, Lebech AM (1992) The clinical and epidemiological profile of Lyme neuroborreliosis in Denmark 1985–1990. A prospective study of 187 patients with Borrelia burgdorferi specific intrathecal antibody production. Brain 115 (Pt 2): 399–423

    PubMed  Google Scholar 

  8. Hauser U, Lehnert G, Wilske B (1999) Validity of interpretation criteria for standardized Western blots (immunoblots) for serodiagnosis of Lyme borreliosis based on sera collected throughout Europe. J Clin Microbiol 37:2241–2247

    CAS  PubMed  Google Scholar 

  9. James DG (1997) Differential diagnosis of facial nerve palsy. Sarcoidosis Vasc Diffuse Lung Dis 14:115–120

    CAS  PubMed  Google Scholar 

  10. Kaiser R (1994) Variable CSF findings in early and late Lyme neuroborreliosis: a follow-up study in 47 patients. J Neurol 242:26–36

    CAS  PubMed  Google Scholar 

  11. Kaiser R (1998) Neuroborreliosis. J Neurol 245:247–255

    Article  CAS  PubMed  Google Scholar 

  12. Kaiser R (2000) False-negative serology in patients with neuroborreliosis and the value of employing of different borrelial strains in serological assays. J Med Microbiol 49:911–915

    CAS  PubMed  Google Scholar 

  13. Kaiser R, Rauer S (1999) Advantage of recombinant borrelial proteins for serodiagnosis of neuroborreliosis. J Med Microbiol 48:5-10

    CAS  PubMed  Google Scholar 

  14. Kaiser R, Rauer S (1999) Serodiagnosis of neuroborreliosis: comparison of reliability of three confirmatory assays. Infection 27:177–182

    CAS  PubMed  Google Scholar 

  15. Karkkonen K, Stiernstedt SH, Karlsson M (2001) Follow-up of patients treated with oral doxycycline for Lyme neuroborreliosis. Scand J Infect Dis 33:259–262

    Article  CAS  PubMed  Google Scholar 

  16. Karlsson M, Hammers-Berggren S, Lindquist L, Stiernstedt G, Svenungsson B (1994) Comparison of intravenous penicillin G and oral doxycycline for treatment of Lyme neuroborreliosis. Neurology 44:1203–1207

    CAS  PubMed  Google Scholar 

  17. Kristoferitsch W, Baumhackl U, Sluga E, Stanek G, Zeiler K (1987) High-dose penicillin therapy in meningopolyneuritis Garin-Bujadoux-Bannwarth. Clinical and cerebrospinal fluid data. Zentralbl Bakteriol Mikrobiol Hyg [A] 263:357–364

    Google Scholar 

  18. Kruger H, Kohlhepp W, Konig S (1990) Follow-up of antibiotically treated and untreated neuroborreliosis. Acta Neurol Scand 82:59–67

    CAS  PubMed  Google Scholar 

  19. Mantienne C, Albucher JF, Catalaa I, Sevely A, Cognard C, Manelfe C (2001) MRI in Lyme disease of the spinal cord. Neuroradiology 43:485–488

    Article  CAS  PubMed  Google Scholar 

  20. Medical Research Council (1976) Aids to the examination of the peripheral nervous system. Her Majesty's Stationary Office, London

  21. Mullegger RR, Millner MM, Stanek G, Spork KD (1991) Penicillin G sodium and ceftriaxone in the treatment of neuroborreliosis in children--a prospective study. Infection 19:279–283

    CAS  PubMed  Google Scholar 

  22. Niemann G, Koksal MA, Oberle A, Michaelis R (1997) Facial palsy and Lyme borreliosis: long-term follow-up of children with antibiotically untreated "idiopathic" facial palsy. Klin Padiatr 209:95–99

    CAS  PubMed  Google Scholar 

  23. Noya M, Pardo J (1997) [Diagnosis and treatment of facial palsy] Diagnostico y tratamiento de la paralisis facial. Neurologia 12:23–30

    CAS  PubMed  Google Scholar 

  24. Pfister HW, Preac-Mursic V, Wilske B, Schielke E, Sorgel F, Einhaupl KM (1991) Randomized comparison of ceftriaxone and cefotaxime in Lyme neuroborreliosis. J Infect Dis 163:311–318

    CAS  PubMed  Google Scholar 

  25. Treib J, Fernandez A, Haass A, Grauer M T, Holzer G, Woessner R (1998) Clinical and serologic follow-up in patients with neuroborreliosis. Neurology 51:1489–1491

    CAS  PubMed  Google Scholar 

  26. Wang ZY, Hansen K, Siden A, Cruz M (1993) Intrathecal synthesis of anti-Borrelia burgdorferi antibodies in neuroborreliosis: a study with special emphasis on oligoclonal IgM antibody bands. Scand J Immunol 37:369–376

    CAS  PubMed  Google Scholar 

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  1. Neurologische Klinik, Städtisches Klinikum Pforzheim

    R. Kaiser

  2. Neurologische Klinik, Städtisches Klinikum Pforzheim, Kanzlerstraße 2–6, 75175, Pforzheim

    R. Kaiser

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Kaiser, R. Verlauf der akuten und chronischen Neuroborreliose nach Behandlung mit Ceftriaxon. Nervenarzt 75, 553–557 (2004). https://doi.org/10.1007/s00115-003-1560-z

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