Halperin J J
Department of Neurology, State University of New York, School of Medicine, Stony Brook 11794.
Rev Infect Dis. 1989 Sep-Oct;11 Suppl 6:S1499-504. doi: 10.1093/clinids/11.supplement_6.s1499.
Objective measures of neurologic function were used to assess response to treatment in patients with late Lyme borreliosis. Neurophysiologic evidence of peripheral neuropathy was present in 64 of 137 patients tested. Measures of distal axon function (sensory amplitude and conduction velocity, motor terminal latency) were most affected. Repeat studies following 60 patients receiving antimicrobial therapy demonstrated significant improvement in these values. Before and after therapy 17 patients with late Lyme borreliosis and prominent subjective cognitive dysfunction underwent neuropsychologic tests of memory, conceptual ability, concentration, psychomotor function, overlearned intellectual abilities, and mood. Significant abnormalities were evident before treatment; all reversed with antimicrobial therapy. Many patients with this encephalopathy had specific abnormalities revealed by magnetic resonance imaging of the brain and had evidence of intrathecal synthesis of antibody to Borrelia. These findings indicate that late Lyme borreliosis commonly causes nervous system abnormalities that are reversible with appropriate antibiotic therapy.
采用客观的神经功能指标来评估晚期莱姆病患者的治疗反应。在137例接受检测的患者中，64例存在周围神经病变的神经生理学证据。远端轴突功能指标（感觉波幅和传导速度、运动终末潜伏期）受影响最大。对60例接受抗菌治疗的患者进行重复检测，结果显示这些指标有显著改善。17例患有晚期莱姆病且有明显主观认知功能障碍的患者在治疗前后接受了记忆、概念能力、注意力、精神运动功能、过度学习的智力能力和情绪方面的神经心理学测试。治疗前明显存在显著异常；抗菌治疗后所有异常均得到逆转。许多患有这种脑病的患者通过脑部磁共振成像显示有特定异常，并有鞘内合成抗伯氏疏螺旋体抗体的证据。这些发现表明，晚期莱姆病通常会导致神经系统异常，适当的抗生素治疗可使其逆转。
