Kohler J
Neurologische Klinik mit Poliklinik, Universität Freiburg.
Fortschr Med. 1990 Apr 10;108(10):191-3, 197.
Neurological manifestations of Lyme disease are as multifarious as the entire spectrum of this common infection. In stage I, fibromyalgia and, more rarely, painful muscular fasciculation, dominate the clinical picture. In the individual case, mild psychic abnormalities may already be observed. Characteristic of the 2nd stage is lymphocytic meningopolyneuritis. Involvements of the CNS are expressed not so much in focal deficits, as in diffuse psychopathological disorders. In stage 3, CNS manifestations are characterized by chronic, in part multifocal, encephalitides and encephalomyelitides, isolated transverse myelitides and cerebral vasculitic disorders. The clinical symptomatology may be dominated by severe psychiatric syndromes. Connatal and subclinical latent infections of the nervous system with Borrelia represent special forms.
莱姆病的神经学表现与这种常见感染的整个范围一样多种多样。在第一阶段,纤维肌痛以及更罕见的疼痛性肌肉束颤在临床表现中占主导地位。在个别病例中,可能已经观察到轻度精神异常。第二阶段的特征是淋巴细胞性脑膜多神经炎。中枢神经系统的受累更多地表现为弥漫性精神病理障碍,而非局灶性缺损。在第三阶段,中枢神经系统表现的特征是慢性、部分为多灶性的脑炎和脑脊髓炎、孤立的横贯性脊髓炎以及脑血管炎性疾病。临床症状可能以严重的精神综合征为主。先天性和亚临床潜伏性神经系统伯氏疏螺旋体感染代表特殊形式。