Halperin J J, Kaplan G P, Brazinsky S, Tsai T F, Cheng T, Ironside A, Wu P, Delfiner J, Golightly M, Brown R H
Department of Neurology, State University of New York, Stony Brook 11794.
Arch Neurol. 1990 May;47(5):586-94. doi: 10.1001/archneur.1990.00530050110021.
Of 19 unselected patients with the diagnosis of amyotrophic lateral sclerosis (ALS) living in Suffolk County, New York (an area of high Lyme disease prevalence), 9 had serologic evidence of exposure to Borrelia burgdorferi; 4 of 38 matched controls were seropositive. Eight of 9 seropositive patients were male (8 of 12 male patients vs 2 of 24 controls). Rates of seropositivity were lower among patients with ALS from nonendemic areas. All patients had typical ALS; none had typical Lyme disease. Cerebrospinal fluid was examined in 24 ALS patients--3 (all with severe bulbar involvement) appeared to have intrathecal synthesis of anti-B burgdorferi antibody. Following therapy with antibiotics, 3 patients with predominantly lower motor neuron abnormalities appeared to improve, 3 with severe bulbar dysfunction deteriorated rapidly, and all others appeared unaffected. There appears to be a statistically significant association between ALS and immunoreactivity to B burgdorferi, at least among men living in hyperendemic areas.
在纽约萨福克县（莱姆病高发地区）确诊为肌萎缩侧索硬化症（ALS）的19例未经挑选的患者中，9例有感染伯氏疏螺旋体的血清学证据；38例匹配对照中有4例血清学阳性。9例血清学阳性患者中有8例为男性（12例男性患者中的8例，24例对照中的2例）。非流行地区的ALS患者血清学阳性率较低。所有患者均患有典型的ALS；无一例患有典型的莱姆病。对24例ALS患者进行了脑脊液检查，其中3例（均有严重延髓受累）似乎有鞘内抗伯氏疏螺旋体抗体合成。抗生素治疗后，3例主要表现为下运动神经元异常的患者似乎有所改善，3例有严重延髓功能障碍的患者迅速恶化，其他患者均未受影响。至少在生活在高度流行地区的男性中，ALS与对伯氏疏螺旋体的免疫反应性之间似乎存在统计学上的显著关联。
