Eguchi Katsuki, Tsuzaka Kazuhumi, Yabe Ichiro, Sasaki Hidenao
Department of Neurology, Kushiro Rosai Hospital.
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University.
Rinsho Shinkeigaku. 2018 Feb 28;58(2):124-126. doi: 10.5692/clinicalneurol.cn-001121. Epub 2018 Jan 31.
A 56-year-old man was sustained ticks at the left axilla and flank. He did not have a rash. About 3 months after the tick bites, he developed back pain, right leg weakness, right abducens nerve palsy, and left facial palsy. Western blot analysis for serum IgM and IgG antibodies against Borrelia were positive. We diagnosed Lyme borreliosis. The patient was treated with antibiotics and steroids, and the symptoms improved. Our findings demonstrate that, even if erythema migrans is not obvious, neuroborreliosis should be considered when neurological signs, such as multiple cranial nerve palsies, are present.
一名56岁男性左侧腋窝和侧腹被蜱虫叮咬。他没有皮疹。蜱虫叮咬约3个月后，他出现背痛、右腿无力、右侧展神经麻痹和左侧面神经麻痹。血清抗伯氏疏螺旋体IgM和IgG抗体的western印迹分析呈阳性。我们诊断为莱姆病。患者接受了抗生素和类固醇治疗，症状有所改善。我们的研究结果表明，即使游走性红斑不明显，当出现多发性颅神经麻痹等神经系统体征时，也应考虑神经莱姆病。
