Gustaw K, Beltowska K, Studzińska M M
Outpatients Neurological Department, Institute of Agricultural Medicine, Jaczewskiego 2, P.O. Box 185, 20-950 Lublin, Poland.
Ann Agric Environ Med. 2001;8(1):91-4.
The purpose of this study was to delineate distant neurological and neuropsychological effects of severe neuroborreliosis. A group of 33 patients (12 men and 21 women) were selected for the study. Every patient had suffered from severe meningitis, meningoencephalitis or meningopolyradiculoneuritis due to neuroborreliosis in the chronic form of the illness. Standardised medical interview, physical examination and a series of neuropsychological tests (WAIS-R, BDI, BENTON-BENDER, DUM) were performed. In the clinical history, 36.4% of the patients complained of headache, 27.3% of subjective memory distortions; 33.3% of the patients suffered from sleeplessness. The neurological examination showed that 36.4% of the patients experienced such cerebellum integrity disturbances as abnormalities in gait and coordination or even mild ataxia. 21.2% of the patients experienced dysfunction in the proprioceptive pathways, 9% asymmetry in deep tendon reflexes (DTR's), 27.3% disturbances in the sensory responses. The examination showed, however, no muscular strength abnormalities. Half of the patients had slight depression. Psychological tests indicated that 21.2% of the patients had problems in thinking process and experienced memory impairment. 36.4% of the patients had significant organic damage in the central nervous system. The results of this study suggest the existence of long-lasting consequences of acute neuroborreliosis, which can significantly influence the quality of life of patients.
本研究的目的是描述严重神经型莱姆病的远期神经学和神经心理学影响。选取了33名患者(12名男性和21名女性)进行研究。每位患者均患有慢性神经型莱姆病所致的严重脑膜炎、脑膜脑炎或脑膜多神经根神经炎。进行了标准化医学访谈、体格检查以及一系列神经心理学测试(韦氏成人智力量表修订版、贝克抑郁量表、本顿视觉保持测验、数字广度测验)。在临床病史方面,36.4%的患者主诉头痛,27.3%的患者有主观记忆扭曲;33.3%的患者存在失眠。神经学检查显示,36.4%的患者出现小脑完整性障碍,如步态和协调性异常甚至轻度共济失调。21.2%的患者本体感觉通路功能障碍,9%的患者深腱反射不对称,27.3%的患者感觉反应障碍。然而,检查未发现肌肉力量异常。半数患者有轻度抑郁。心理测试表明,21.2%的患者思维过程存在问题并伴有记忆障碍。36.4%的患者中枢神经系统有明显器质性损害。本研究结果提示急性神经型莱姆病存在长期后果,可显著影响患者的生活质量。