Kubová Zuzana, Szanyi Jana, Langrová Jana, Kremlácek Jan, Kuba Miroslav, Honegr Karel
Department of Pathophysiology, Charles University in Prague, Faculty of Medicine in Hradec Králové, Czech Republic.
J Clin Neurophysiol. 2006 Oct;23(5):416-20. doi: 10.1097/01.wnp.0000218241.95542.4f.
Neuroborreliosis is a form of borreliosis that affects the central and/or peripheral nervous system. Although it can mimic neurologic and ophthalmologic disorders such as multiple sclerosis and optic neuritis, visual evoked potential (VEP) examination is usually not used in neuroborreliosis diagnostics. Combined VEP testing (pattern-reversal VEPs and VEPs produced in response to linear and radial motion) was performed in 81 patients with neuroborreliosis verified by laboratory results (positive polymerase chain reaction or intrathecal antibodies production). Thirty-four patients reported diplopia or blurred vision related to borreliosis. In 33 (40%) patients the VEPs were delayed: motion-onset VEPs were pathologic in 22 (27%) patients, reversal VEPs in 5 (6%) patients, and both VEP types in 6 (7%) patients. The findings suggest that VEP testing (especially the motion-onset VEP testing) can confirm CNS involvement. Much higher sensitivity of motion-onset VEPs in comparison with reversal VEPs can result from rather selective (earlier) involvement of the magnocellular system or the dorsal stream of the visual pathway.
神经型莱姆病是莱姆病的一种形式，可影响中枢和/或周围神经系统。尽管它可能会模仿诸如多发性硬化症和视神经炎等神经和眼科疾病，但视觉诱发电位（VEP）检查通常不用于神经型莱姆病的诊断。对81例经实验室检查结果证实（聚合酶链反应阳性或鞘内抗体产生）的神经型莱姆病患者进行了联合VEP测试（图形翻转VEP以及对线性和径向运动产生的VEP）。34例患者报告有与莱姆病相关的复视或视力模糊。33例（40%）患者的VEP出现延迟：22例（27%）患者的运动起始VEP异常，5例（6%）患者的翻转VEP异常，6例（7%）患者的两种VEP类型均异常。这些发现表明VEP测试（尤其是运动起始VEP测试）可以证实中枢神经系统受累。与翻转VEP相比，运动起始VEP具有更高的敏感性，这可能是由于大细胞系统或视觉通路背侧流的选择性（更早）受累所致。
