Krabbe Niels Valdemar, Jensen Tove Ejlertsen, Nielsen Henrik Ib
Infektionsmedicinsk Afdeling, Aalborg Sygehus, DK-9000 Aalborg.
Ugeskr Laeger. 2008 Oct 20;170(43):3420-4.
Infection with Borrelia sp. is common in Denmark, and dissemination to the central nervous system (neuroborreliosis) may develop in a minority of cases with varying symptoms. We here present a population-based review of neuroborreliosis in Northern Denmark.
We identified 84 patients with neuroborreliosis from North Jutland County in the period 1998-2006 based on the demonstration of intrathecal antibody production to B. burgdorferi, and we reviewed the medical records for symptoms, diagnosis, treatment and outcome.
Paresis of the facialis nerve and fever were more common among children than among adults, whereas radiculitis and sensory symptoms were more frequent among adults than among children. Eight of 84 patients (10%) reported only nonneurological symptoms. All patients were treated with antibiotics for at least ten days. Information on outcome was available for 76 patients (90%) of whom 16 (19%) had persistent sequelae after six months. Patients with persistent sequelae had a lower cell count in the cerebrospinal fluid than patients without sequelae. Patients with a diagnostic delay of less than 28 days had less sequelae than patients with a delay longer than 28 days.
Symptoms in neuroborreliosis are heterogeneous, although some symptoms are common in children while others are predominant in adults. Early diagnosis of neuroborreliosis potentially improves the outcome.
丹麦感染伯氏疏螺旋体很常见,少数病例可能会扩散至中枢神经系统(神经莱姆病),症状各异。我们在此对丹麦北部的神经莱姆病进行基于人群的综述。
我们根据鞘内抗伯氏疏螺旋体抗体产生情况,在1998年至2006年期间从北日德兰郡确定了84例神经莱姆病患者,并查阅了病历以了解症状、诊断、治疗和结果。
面神经麻痹和发热在儿童中比在成人中更常见,而神经根炎和感觉症状在成人中比在儿童中更频繁。84例患者中有8例(10%)仅报告了非神经症状。所有患者均接受了至少十天的抗生素治疗。76例患者(90%)有结局信息,其中16例(19%)在六个月后有持续后遗症。有持续后遗症的患者脑脊液中的细胞计数低于无后遗症的患者。诊断延迟少于28天患者的后遗症比延迟超过28天的患者少。
神经莱姆病的症状具有异质性,尽管有些症状在儿童中常见,而有些症状在成人中占主导。神经莱姆病的早期诊断可能会改善结局。