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Meningopolyneuritis bannwarth with focal nodular myositis

A new aspect in Lyme borreliosis

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Summary

A patient with serologically confirmed infection byBorrelia burgdorferi presenting with painful paresis and atrophy of the proximal muscles of both upper extremities and bilateral facial paresis is described. Electromyography showed a neurogenic and myopathic pattern, and creatine kinase was raised. Muscle biopsy revealed the typical signs of focal myositis. Treatment with i.v. penicillin led to dramatic clinical and serological improvement. Muscle biopsy was repeated 2 months later; neurogenic changes were still present, but no inflammatory signs could be seen anymore. Thus, the presented case may be the first reported of meningopolyneuritis accompanied by focal nodular myositis, in the second stage of Lyme borreliosis.

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Abbreviations

B. burgdorferi :

Borrelia burgdorferi

C:

Complement

CK:

Creatine kinase

CSF:

Cerebrospinal fluid

ECM:

Erythema chronicum migrans

EMG:

Electromyography

ESR:

Erythrocyte sedimentation rate

HE:

hematoxylin eosin

IgG:

Immunoglobulin G

IgM:

Immunoglobulin M

IIFT:

Indirect immunofluorescence test

LB:

Lyme borreliosis

NCV:

Nerve conduction velocity

TPHA:

Treponema pallidum hemagglutination test

References

  1. Ackermann R, Boisten HP, Kabatzki J, Runne U, Krüger K, Hermann WP (1984) Serumantikörper gegen Ixodes-ricinus-Spirochäte bei Acrodermatitis chronica atrophicans (Herxheimer) Dtsch Med Wochenschr 109:6–10

    Google Scholar 

  2. Ackermann R, Gollmer E, Rehse-Küpper B (1985) Progressive Borrelien-Encephalitis. Dtsch Med Wochenschr 110:1039–1042

    Google Scholar 

  3. Barbour AG, Stanek G (1986) Lyme Borreliosis Newsletter 1/1:4

    Google Scholar 

  4. Benach JL, Bosler EM, Hanrahan JP, Coleman JL, Habicht GS, Bast TF, Cameron DH, Ziegler JL, Barbour AG, Burgdorfer W, Edelman R, Kaslow RA (1983) Spirochetes isolated from the blood of two patients with Lyme disease. N Engl J Med 308:740–742

    Google Scholar 

  5. Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grundwaldt E, Davis JP (1982) Lyme disease — a thick-borne spirochetosis? Science 216:1317–1319

    Google Scholar 

  6. Dubowitz V, Brooke MH (1973) Muscle biopsy: a modern approach. Saunders, London Philadelphia Toronto

    Google Scholar 

  7. Hindfeldt B, Jeppson PG, Nilsson B, Olsson JE, Ryberg B, Sörnäs R (1982) Clinical and cerebrospinal-fluid findings in lymphocytic meningo-radiculitis (Bannwarth's syndrome). Acta Neurol Scand 66:444–453

    Google Scholar 

  8. Johnson RC, Schmid GP, Hyde FW, Steigerwaldt AG, Brenner DJ (1984)Borrelia burgdorferi sp.nov.: etiologic agent of Lyme disease. Int J Syst Bact 34:496–497

    Google Scholar 

  9. Klenk W, Heitmann R, Ackermann R (1985) Rezidivierende Erythema-chronicum-migrans-Krankheit des Nerven-systems: Querschnittsmyelitis als Rückfall einer Meningopolyneuritis Garin-Bujadoux-Bannwarth. Akt Neurol 12:20–23

    Google Scholar 

  10. Pachner AR, Steere AC (1985) The triad of neurologic manifestations of Lyme disease: meningitis, cranial neuritis and radiculoneuritis. Neurology 35:47–53

    Google Scholar 

  11. Pachner AR, Steere AC (1985) Tertiary Lyme disease — central nervous system manifestations of longstanding infection withB. burgdorferi. Second international symposium on Lyme disease and related disorders. Vienna, Austria, 17–19 September, Compendium of Abstracts, p 38

  12. Pfister HW, Einhäupl K, Preac-Mursic V (1984) The spirochetal etiology of lymphocytic meningoradiculitis Bannwarth (Bannwarth's syndrome). J Neurol 231:141–144

    Google Scholar 

  13. Reik L, Steere AC, Bartenhagen NH, Shope RE, Malawista SE (1979) Neurologic abnormalities of Lyme disease. Medicine (Baltimore) 58:281–294

    Google Scholar 

  14. Ryberg B, Nilsson B, Burgdorfer W, Barbour AG (1983) Antibodies of Lyme disease spirochaete in European lymphocytic meningoradiculitis (Bannwarth's syndrome) Lancet II:519

    Google Scholar 

  15. Schmid GP (1985) The global distribution of Lyme disease. Rev Infect Dis 7:41–50

    Google Scholar 

  16. Schmutzhard E, Stanek G, Pohl P (1985) Polyneuritis cranialis associated withB. burgdorferi. J Neurol Neurosurg Psychiatry 48:1182–1184

    Google Scholar 

  17. Smolen JS, Luger TA, Neumann R, Kristoferitsch W, Stanek G, Graniger W (1984) Die Lyme-Krankheit — eine weitere durch Zecken übertragene Erkrankung in Österreich. Wien Klin Wochenschr 96:823–829

    Google Scholar 

  18. Stanek G (1984) Zecken als Überträger von Borrelien in Österreich. Hygiene Aktuell 1:1–3

    Google Scholar 

  19. Stanek G, Flamm H (1985) Epidemiologie von Borrelia-Infektionen in Österreich. Österr Ärztez 4:19–22

    Google Scholar 

  20. Stanek G, Hirschl A (1986) IFA, ELISA and Immunoblot zur Serodiagnostik von Berrelia-Infektion. Mitt Öst Ges Tropenmed Parasitol 8 (in press)

  21. Stanek G, Kristoferitsch W, Hirschl A, Wewalka G (1985) Borrelia-Infektionen in Österreich 1984. Mitt Öst Ges Tropenmed Parasitol 7:55–62

    Google Scholar 

  22. Steere AC, Malawista SE, Hardin JA, Ruddy S, Askenase PE, Andiman WA (1977) Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. Ann Int Med 86:685–689

    Google Scholar 

  23. Steere AC, Malawista SE, Snydman DR, Shope RE, Andiman WA, Ross MR, Steele FM (1977) Lyme-arthritis: an epidemic of oligo-articular arthritis in children and adults in three Connecticut communities. Arthritis Rheum 20:7–17

    Google Scholar 

  24. Steere AC, Batsford WP, Weinberg M, Alexander J, Berger HJ, Wolfson S, Malawista SE (1980) Lyme carditis: cardiac abnormalities of Lyme disease. Ann Intern Med 93:8–16

    Google Scholar 

  25. Steere AC, Bartenhagen NH, Craft JE, Hutchinson GJ, Newman JH, Rahn DW, Sigal LH, Spieler PN, Stenn KS, Malawista SE (1983) The early clinical manifestations of Lyme disease. Ann Intern Med 99:76–82

    Google Scholar 

  26. Steere AC, Grodzicki RL, Kornblatt AN, Craft JE, Barbour AG, Burgdorfer W, Schmid GP, Jonson E, Malawista SE (1983) The spirochetal etiology of Lyme disease. N Engl J Med 308:733–740

    Google Scholar 

  27. Steere AC, Pachner AR, Malawista SE (1983) Neurologic abnormalities as Lyme disease: successful treatment with high-dose intravenous penicillin. Ann Intern Med 99:767–772

    Google Scholar 

  28. Steere AC, Bartenhagen NH, Carft JE, Hutchinson GJ, Newmann JH, Pachner AR, Rahn DW, Sigal LH, Spieler PN, Taylor E, Malawista SE (1985) Clinical manifestations of Lyme disease. Second international symposium on Lyme disease and related disorders. Vienna, Austria, 17–19 September, Compendium of Abstracts, p 30

  29. Steere AC, Green J, Hutchinson GJ, Rahn DW, Pachner AR, Schoen RT, Sigal LH, Taylor E, Malawista SE (1985) Treatment of Lyme disease and related disorders. Vienna, Austria, 17–19 September. Compendium of Abstracts, p 52

  30. Uldry PA, Steck AJ, Regli F (1986) Manifestations neurologiques des infections àBorrelia burgdorferi. Schweiz Med Wochenschr 116/5:135–142

    Google Scholar 

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  1. Universitätsklinik für Neurologie Innsbruck, Austria

    E. Schmutzhard, J. Willeit & F. Gerstenbrand

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  1. E. Schmutzhard
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  2. J. Willeit
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  3. F. Gerstenbrand
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Schmutzhard, E., Willeit, J. & Gerstenbrand, F. Meningopolyneuritis bannwarth with focal nodular myositis. Klin Wochenschr 64, 1204–1208 (1986). https://doi.org/10.1007/BF01728463

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