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Early Neurological Involvement (Bannwarth’s Syndrome)

  • H. W. Pfister
  • W. Kristoferitsch
  • C. Meier

Abstract

The nomenclature for the neurological manifestations of Borrelia burgdorferi infections is confusing and not uniformly used. In the literature, the terms used include Bannwarth’s syndrome (Meyer-Rienecker and Hitzschke 1977), meningopolyneuritis Garin-Bujadoux-Bannwarth (Hörstrup and Ackermann 1973), Borrelia meningitis (Hansen et al. 1986), erythema chronicum migrans meningitis (Weber 1974), radiculomyelomeningitis after tick bite (Schaltenbrand 1962), meningomyeloradiculitis after tick bite with erythema (Bammer and Schenk 1965), neuroborreliosis (Stiernstedt et al. 1988), and Lyme neuroborreliosis (Halperin et al. 1989). In addition, these terms confuse the neurological manifestations during the early disseminated infection and those in chronic late infection. All these terms have disadvantages; for example, Bannwarth’s syndrome is characterized by painful meningoradiculoneuritis (Bannwarth 1941). Use of the word “meningitis” is not advisable because, despite the inflammatory cerebrospinal fluid (CSF) syndrome, patients in Europe usually do not suffer from the typical signs or symptoms of meningitis such as headache, stiff neck, fever, vomiting, and photophobia. The term “neuroborreliosis” is nonspecific because other borrelial infections such as relapsing fever may also cause neurological manifestations. Thus, the term Lyme neuroborreliosis seems to be most suitable to describe the neurological manifestations of B. burgdorferi infection including early and late manifestations.

Keywords

Lyme Disease Neurological Manifestation Borrelia Burgdorferi Lyme Borreliosis Erythema Migrans 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Aberer E, Brunner C, Suchanek G, Klade H, Barbour AG, Stanek G, Lassmann H (1989) Molecular mimicry and Lyme borreliosis: a shared antigenic determinant between Borrelia burgdorferi and human tissue. Ann Neurol 26: 732–737PubMedCrossRefGoogle Scholar
  2. Ackermann R, Rehse-Küpper B, Gollmer E, Schmidt R (1988) Chronic neurologic manifestations of erythema migrans borreliosis. Ann NY Acad Sci 539: 16–23PubMedCrossRefGoogle Scholar
  3. Asbrink E, Olsson I (1985) Clinical manifestations of erythema chronicum migrans Afzelius in 161 patients. Acta Derm Venereol Stockholm 65: 43–52Google Scholar
  4. Asbrink E, Hovmark A, Olsson I (1986) Clinical manifestations of acrodermatitis chronic atrophicans in 50 Swedish patients. Zentralbl Bakteriol Hyg A 263: 253–261Google Scholar
  5. Atlas E, Novak SN, Duray PH, Steere AC (1988) Lyme myositis: muscle invasion by Borrelia burgdorferi. Ann Intern Med 109: 245–246PubMedGoogle Scholar
  6. Bammer HG (1981) Meningomyeloradikulitis nach Zeckenbiß mit Erythem. In: Hopf HC, Poeck K, Schliack H (eds), Neurologie in Praxis und Klinik, Vol 2. Thieme, Stuttgart, New York, pp 4.233–4.235Google Scholar
  7. Bammer H, Schenk K (1965) Meningo-Myelo-Radikulitis nach Zeckenbiß mit Erythem. Dtsch Z Nervenheilkunde 187: 25–34CrossRefGoogle Scholar
  8. Bannwarth A (1941) Chronische lymphozytäre Meningitis, entzündliche Polyneuritis und Rheumatismus. Arch Psychiatr Nervenkr 113: 284–376CrossRefGoogle Scholar
  9. Baumhackl U, Kristoferitsch W, Sluga E, Stanek G (1986) Neurological manifestation of Borrelia burgdorferi-infections: the enlarging clinical spectrum. Zentralbl Bakteriol Hyg A 263: 334–336Google Scholar
  10. Bendig JWA, Ogilvie D (1987) Severe encephalopathy associated with Lyme disease. Lancet I: 681–682CrossRefGoogle Scholar
  11. Camponovo F, Meier C (1986) Neuropathy of vasculitic origin in a case of Garin-Bujadoux-Bannwarth syndrome with positive borrelial antibody response. J Neurol 233: 69–72PubMedCrossRefGoogle Scholar
  12. Dieterle L, Kubina FG, Staudacher T, Büdingen HJ (1989) Neuroborreliose oder Bandscheibenvorfall. Dtsch Med Wochenschr 114: 1602–1606PubMedCrossRefGoogle Scholar
  13. Dumas M (1989) Antibodies against nervous tissue antigens in sera of patients with positive Lyme-serology. 9th Peripheral Nerve Study Group Meeting, Padova (abstract)Google Scholar
  14. Engelhardt A, Grahmann F, Neundörfer B (1989) Vasculitic neuropathy in a case of Bannwarth’s syndrome. Zentralbl Bakteriol (Suppl) 18: 136–140Google Scholar
  15. Erbslöh F, Kohlmeyer K (1968) Über polytope Erkrankungen des peripheren Nervensystems bei lymphozytärer Meningitis. Fortschr Neurol Psychiatr 36: 321–342Google Scholar
  16. Felgenhauer K (1982) Differentiation of the humoral immune response in inflammatory diseases of the central nervous system. J Neurol 228: 223–237PubMedCrossRefGoogle Scholar
  17. Garcia-Monco JC, Coleman JL, Benach JL (1988) Antibodies to myelin basic protein in Lyme disease. J Infect Dis 158:667 (letter)Google Scholar
  18. Glauser TA, Brennan PJ, Galetta SL (1989) Reversible Horner’s syndrome and Lyme disease. J Clin Neuro ophthalmol 9: 225–228Google Scholar
  19. Gollmer E, Schmidt R, Kabatzki J, Härtung S, Rehse-Küpper B, Ackermann R (1989) Borrelia meningopolyneuritis Garin-Bujadoux-Bannwarth, catamnesis of 25 cases. Zentralbl Bakteriol (Suppl) 18: 206–211Google Scholar
  20. Graf M, Kristoferitsch W, Baumhackl U, Zeitlhofer J (1986) Electrophysiologic findings in meningopolyneuritis of Garin-Bujadoux-Bannwarth. Zentralbl Bakteriol Hyg (A) 263: 324–327Google Scholar
  21. Habicht GS, Beck G, Benach JL (1988) The role of interleukin-1 in the pathogenesis of Lyme disease. Ann N Y Acad Sci 539:80–86PubMedCrossRefGoogle Scholar
  22. Hänny PE, Häuselmann HJ (1987) Die Lyme-Krankheit aus der Sicht des Neurologen. Schweiz Med Wochenschr 117:901–915PubMedGoogle Scholar
  23. Halperin JJ, Luft BJ, Anand AK, Roque CT, Alvarez O, Volkman DJ, Dattwyler RJ (1989) Lyme neuroborreliosis: central nervous system manifestations. Neurology 39: 753–759PubMedGoogle Scholar
  24. Hanner P, Rosenhall U, Edström S, Kaijser B (1989) Hearing impairment in patients with antibody production against Borrelia burgdorferi antigen. Lancet I: 13–15CrossRefGoogle Scholar
  25. Hansen K, Cruz M, Link H (1990) Oligoclonal Borrelia burgdorferi — specific IgG antibodies in cerebrospinal fluid in Lyme neuroborreliosis. J Infect Dis 161:1194–1202PubMedCrossRefGoogle Scholar
  26. Hansen K, Rechnitzer C, Pedersen NS, Arpi M, Jessen O (1986) Borrelia meningitis in Denmark. Zentralbl Bakteriol Hyg (A) 263:348–350Google Scholar
  27. Hellerström S (1930) Erythema chronicum migrans Afzelii. Acta Derm Venereol Stockholm 11: 315–321Google Scholar
  28. Henriksson A, Link H, Cruz M, Stiernstedt G (1986) Immunglobulin abnormalities in cerebrospinal fluid and blood over the course of lymphocytic meningoradiculitis (Bannwarth’s syndrome). Ann Neurol 20: 337–345Google Scholar
  29. Hoffmann H, Heinz FX, Dippe H (1983) ELISA for IgM and IgG antibodies against tick-borne encephalitis virus: quantification and standardization of results. Zentral Bakteriol Hyg A 255: 448–455Google Scholar
  30. Hörstrup P, Ackermann R (1973) Durch Zecken übertragene Meningopolyneuritis (Garin-Bujadoux, Bannwarth). Fortschr Neurol Psychiatr 41: 583–606Google Scholar
  31. Kohler I, Thoden U (1987) Schmerzsyndrom bei Zeckenübertragenen Borrelieninfektionen des Nervensystems. Klinik und Differentialdiagnose Schmerz 1: 107–113Google Scholar
  32. Kohlhepp W, Mertes HG, Oschmann P, Rohrbach E (1987) Akute und chronische Erkrankungen bei zeckenvermitteler Borreliose. Nervenarzt 58: 557–563PubMedGoogle Scholar
  33. Kristoferitsch W (1989) Neuropathien bei Lyme-Borreliose. Springer, Wien New YorkCrossRefGoogle Scholar
  34. Kristoferitsch W, Spiel G, Wessely P (1983) Zur Meningopolyneuritis (Garin-Bujadoux, Bannwarth). Klinik und Laborbefunde. Nervenarzt 54: 640–646Google Scholar
  35. Kristoferitsch W, Stanek G, Kunz C (1986) Doppelinfektion mit Frühsommermeningoenzephalitis (FSME) — Virus und Borrelia burgdorferi.Dtsch Med Wochenschr 111: 861–864PubMedCrossRefGoogle Scholar
  36. Krüger H, Englert D, Pflughaupt KW (1981) Demonstration of oligoclonal immunoglobulin G in Guillain-Barré syndrome and lymphocytic meningoradiculitis by isoelectric focusing. J Neurol 226: 15–24PubMedCrossRefGoogle Scholar
  37. Krüger H, Reuss K, Pulz M, Rohrbach E, Pflughaupt KW, Martin R, Mertens HG (1989) Meningoradiculitis and encephalomyelitis due toBorrelia burgdorferi: a follow-up study of 72 patients over 27 years. J Neurol 236: 322–328PubMedCrossRefGoogle Scholar
  38. Krüger H, Kohlhepp W, König S (1990) Follow up of antibiotically treated and untreated neuroborreliosis. Acta Neurol Scand 82: 59–67PubMedCrossRefGoogle Scholar
  39. Kuntzer T, Bogousslavsky J, Miklossy J, Steck AJ, Janzer R, Regli F (1991) Borrelia Rhomb-encephalomyelopathy. Arch Neurol 48: 832–836PubMedGoogle Scholar
  40. Maida E, Kristoferitsch W, Spiel G (1986) Liquorveränderungen bei Meningoradiculitis Garin-Bujadoux-Bannwarth. Nervenarzt 57: 149–152PubMedGoogle Scholar
  41. Martin R, Ortlauf J, Sticht-Groh V, Bogdahn U, Goldmann SF, Mertens HG (1988) Borrelia burgdorferi-specific and autoreactive T-cell lines from cerebrospinal fluid in Lyme radicu- lomyelitis. Ann Neurol 24: 509–516Google Scholar
  42. May EF, Jabbari B (1990) Stroke in neuroborreliosis. Stroke 21: 1232–1235PubMedCrossRefGoogle Scholar
  43. Meier C, Grahmann F, Engelhardt A, Dumas M (1989) Peripheral nerve disorders in Lyme Borreliosis. Nerve biopsy studies from eigth cases. Acta Neuropath 79: 271–278PubMedCrossRefGoogle Scholar
  44. Meier C, Reulen HJ, Huber P, Mummentahler M (1989) Meningoradiculoneuritis, mimicking vertebral disk herniation. A “neurosurgical” complication of Lyme borreliosis. Acta Neurochir (Wien) 98: 42–46CrossRefGoogle Scholar
  45. Meyer-Rienecker HJ, Hitzschke B (1977) Lymphocytic meningoradiculitis (Bannwarth’s syndrome). In: Vinken PJ, Bruyn GW(eds) pp 571–586 Handbook of clinical neurology vol 34, AmsterdamGoogle Scholar
  46. Murray N, Kristoferitsch W, Stanek G, Steck AJ (1986) Specificity of CSF antibodies against components ofBorrelia burgdorferi in patients with meningopolyneuritis Garin-Bujadoux- Bannwarth. J Neurol 233: 224–227PubMedCrossRefGoogle Scholar
  47. Neubert U, Krampitz HE, Engl H (1986) Microbiological findings in erythema (chronicum) migrans and related disorders. Zentralbl Bakteriol Hyg A 263: 237–252Google Scholar
  48. Pachner AR, Steere AC (1985) The triad of neurologic manifestations of Lyme disease: meningitis, cranial neuritis, and radiculoneuritis. Neurology 35: 47–53PubMedGoogle Scholar
  49. Pfister HW, Einhäupl KM (1988) Die neurologisch manifeste Lyme-Borreliose. In: Elger CE, Dengler R (eds) Jahrbuch der Neurologie. Biermann S 63–70Google Scholar
  50. Pfister HW, Einhäupl KM, Preac-Mursic V, Wilske B (1985) Similarity of neurologic manifestations of Borrelia burgdorferi infections in America and Europe. Neurology 35: 1393–1394Google Scholar
  51. Pfister HW, Einhäupl KM, Wilske B, Preac-Mursic V (1986) Bannwarth’s syndrome and the enlarged neurological spectrum of arthropod borne borreliosis. Zentralbl Bakteriol Hyg A 263: 343–347Google Scholar
  52. Pfister HW, Wilske B, Preac-Mursic V, Einhäupl KM (1989) Clinical and serological follow up of patients with Bannwarth’s syndrome: comparison of patients with and without penicillin treatment. In: Zentralbl Bakteriol Suppl 18: 276–279Google Scholar
  53. Pfister HW, Rieder G, Förderreuther S, Wilske B, Preac-Mursic V, Kapfhammer HP, Einhäupl KM (1991) Atypical neurologic manifestations of Lyme Borreliosis. Presented at the 17th International Congress of Chemotherapy 23 – 28 June 1991, Berlin (abstract)Google Scholar
  54. Queisser H (1962) Beobachtungen über einige Fälle von Zeckenenzephalitis in Deutschland. Munch Med Wochenschr 104: 2288–2293PubMedGoogle Scholar
  55. Radi B, Ladurner G, Lechner H, Stunzer D (1983) Klinik und Verlauf der Frühsommermeningoenzephalitis (FSME, TBE). Neuropsychiatr Clin 2: 131–135Google Scholar
  56. Raucher HS, Kaufman DM, Goldfarb J, Jacobsen RI, Roseman B, Wolff RR (1985) Pseudotumor cerebri and Lyme disease: a new association. J Pediatr 6: 931–933Google Scholar
  57. Razavi-Encha F, Fleury-Feith J, Gherardi R, Bernaudin JF (1987) Cytologic features of cerebral spinal fluid in Lyme disease. Acta Cytologica 31: 439–440PubMedGoogle Scholar
  58. Reimers CD, Pongratz DE, Neubert U, Pilz A, Hübner G, Naegele M, Wilske B, Duray PH, DeKoning J (1989) Myositis caused by Borrelia burgdorferi.Report of 4 patients. J Neurol Sci 91: 215–226PubMedCrossRefGoogle Scholar
  59. Reisner H (1969) Die akute Polyradikulitis. Z Nervenheilkunde 27: 269–276Google Scholar
  60. Reisner H (1981) Clinic and treatment of tick-borne encephalitis (TBE). Introduction. In: Kunz C (ed) Facultas, Vienna, pp 1–5 Tick-borne encephalitis. International symposium, Baden/Vienna 1979Google Scholar
  61. Rohmer F, Collard M, Jesel M, Warter JM, Coquillat G, Class JJ (1974) Les meningoradiculitides: données cliniques, electromyographiques et ètiologiques â propos de 36 observations. Limites nosologiques. Rev Neurol 130: 415–431Google Scholar
  62. Schaltenbrand G (1962) Radiculomyelomeningitis nach Zeckenbiß. Munch Med Wochenschr 104: 829–834PubMedGoogle Scholar
  63. Schaltenbrand G (1967) Durch Arthropoden übertragene Infektionen der Haut und des Nervensystems. Verh Dtsch Ges Inn Med 72: 975–1005Google Scholar
  64. Schmidt R, Ackermann R (1985) Durch Zecken übertragene Meningo-Polyneuritis (Garin- Bujadoux, Bannwarth). Erythema chronicum migrans Krankheit des Nervensystems. Fortschr Neurol Psychiatr 53: 145–153Google Scholar
  65. Schmidt R, Kabatzki J, Hartung S, Ackermann R (1985) Erthema-migrans-Borreliose in der Bundesrepublik Deutschland. Dtsch med Wochenschr 110: 1803–1807PubMedCrossRefGoogle Scholar
  66. Schmutzhard E, Stanek G, Pohl P (1985) Polyneuritis cranialis associated with Borrelia burgdorferi.J Neurol Neurosurg Psychiatr 48: 1182–1184PubMedCrossRefGoogle Scholar
  67. Schmutzhard E, Willeit J, Gerstenbrand F (1986) Meningopolyneuritis Bannwarth with focal nodular myositis. Klin Wochenschr 64: 1204–1208PubMedCrossRefGoogle Scholar
  68. Schmutzhard E, Pohl P, Stockhammer G, Kleedorfer B, Stanek G (1988) Unusual neurological manifestations of Lyme borreliosis. Ann NY Acad Sci 539: 495–496CrossRefGoogle Scholar
  69. Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M (1989) Myositis during Borrelia burgdorferi infection (Lyme disease). J Neurol Neurosurg Psychiatry 52: 1002–1005Google Scholar
  70. Schroeter V, Beiz GG, Blenk H (1988) Paralysis of recurrent laryngeal nerve in Lyme disease. Lancet II: 1245Google Scholar
  71. Sigal LH, Tatum AH (1988) Lyme disease patients’ serum contains IgM antibodies to Borrelia burgdorferi that cross-react with neuronal antigens. Neurology 38: 1439–1442PubMedGoogle Scholar
  72. Sköldenberg B, Stiernstedt G, Garde A, Kolmodin G, Carlström A, Nord CE (1983) Chronic meningitis caused by a penicillin-sensitive microorganism? Lancet II: 75–78Google Scholar
  73. Sterman AB, Nelson S, Barclay P (1982) Demyelinating neuropathy accompanying Lyme disease. Neurology 32: 1302–1305PubMedGoogle Scholar
  74. Stiernstedt G, Sköldenberg B, Vandvik B, Hederstedt B, Garde A, Kolmodin G, Jörböck H, Svenungsson B (1984) Chronic meningitis and Lyme disease in Sweden. Yale J Biol Med 57: 491–497PubMedGoogle Scholar
  75. Stiernstedt GT, Granström M, Hederstedt B, Sköldenberg B (1985) Diagnosis of spirochetal meningitis by enzyme-linked immunosorbent assay and indirect immunofluorescence assay in serum and cerebrospinal fluid. J Clin Microbiol 21: 819–825PubMedGoogle Scholar
  76. Stiernstedt GT, Sköldenberg B, Garde A, Kolmodin G, Jörbeck H, Svenungsson B, Carlström A (1986) Clinical manifestations of borrelia infections of the nervous system. Zentralbl Bakteriol Hyg A 263: 289–296Google Scholar
  77. Stiernstedt G, Gustafsson R, Karlsson M, Svenungson B, Sköldenberg B (1988) Clinical manifestation and diagnosis of neuroborreliosis. Ann NY Acad Sci 539: 46–55PubMedCrossRefGoogle Scholar
  78. Suchanek G, Kristoferitsch W, Stanek G, Bernheimer H (1986) Anti-myelin antibodies in cerebrospinal fluid and serum of patients with meningopolyneuritis Garin-Bujadoux-Bannwarth and other neurological diseases. Zentralbl Bakteriol Hyg A 263: 160–168Google Scholar
  79. Vallat JM, Leboutet MJ, Lubeau M, Dumas M, Hugon J, Corvisier N (1984) Tick bite neuropathy: an analysis of nerve biopsies from seven patients. Neurology 34 (Suppl 1): 180–181Google Scholar
  80. Vallat JM, Hugon J, Lubeau M, Leboutet MJ, Dumas M, Desproges-Gotteron (1987) Tick-bite meningoradiculoneuritis: clinical, electrophysiologic, and histologic findings in 10 patients. Neurology 37: 749–753Google Scholar
  81. Veenendaal-Hilbers JA, Perquin WVM, Hoogland PH, Doornbos L (1988) Basal meningovascu- litis and occlusion of the basilar artery in two cases ofBorrelia burgdorferi infection. Neuroradiology 38: 1317–1319Google Scholar
  82. Weber K (1974) Erythema-chronicum-migrans-Meningitis — eine bakterielle Infektionskrankheit? Munch Med Wochenschr 116: 1993–1998Google Scholar
  83. Weber K, Neubert U (1986) Clinical features of early erythema migrans disease and related disorders. Zentralbl Bakteriol Hyg (A) 263: 209–228Google Scholar
  84. Weber T, Jürgens S, Lüer W (1987) Cerebrospinal fluid immunogloblins and virus-specific antibodies in disorders affecting the facial nerve. J Neurol 234: 308–314PubMedCrossRefGoogle Scholar
  85. Wenig C (1975) Chronische lymphozytäre Meningitis mit polytoper Beteiligung des Nervensystems (nach Zeckenbiß?). Psychiatr Neurol Med Psychol (Leipz) 27: 592–600Google Scholar
  86. Wolf G (1970) Über die chronische lymphozytäre Meningitis unter dem Bilde der Polyneuritis (Bannwarth). Fortsch Neurol Psychiatr 38: 221–234Google Scholar
  87. Wulff C, Hansen K, Strange P, Trojyborg W (1983) Multiple mononeuritis and radiculitis with erythema, pain, elevated CSF protein and pleocytosis (Bannwarth’s syndrome). J Neurol Neurosurg Psychiatry 46: 485–490PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • H. W. Pfister
  • W. Kristoferitsch
  • C. Meier

There are no affiliations available

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