Rey V, Du Pasquier R, Muehl A, Péter O, Michel P
Service de neurologie, département des neurosciences cliniques, centre hospitalier universitaire Vaudois, BH 13, 1011 Lausanne, Switzerland.
Rev Neurol (Paris). 2010 Nov;166(11):931-4. doi: 10.1016/j.neurol.2010.03.010.
The most frequent clinical manifestation of borreliosis in Switzerland is erythema migrans, with about 2500 patients each year. Neurological manifestations are rare, mostly hyperalgesic radiculitis (Bannwarth syndrome), aseptic meningitis or cranial nerve involvement. We report the first Swiss patient with meningovasculitis due to neuroborreliosis, with recurrent multiple ischemic strokes in multiple vascular territories. The treatment with ceftriaxone stopped the progression, but the patient is still suffering from severe invalidating cognitive disorders. We also comment on the pathophysiology and review the literature of other clinical cases.
在瑞士,莱姆病最常见的临床表现是游走性红斑,每年约有2500例患者。神经系统表现较为罕见,主要是痛觉过敏型神经根炎(班沃特综合征)、无菌性脑膜炎或颅神经受累。我们报告了瑞士首例因神经型莱姆病导致脑膜血管炎的患者,该患者在多个血管区域反复发生多发性缺血性中风。头孢曲松治疗阻止了病情进展,但患者仍患有严重的致残性认知障碍。我们还对病理生理学进行了评论,并回顾了其他临床病例的文献。