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节肢动物叮咬后由螺旋体(伯氏疏螺旋体)引起的脑脊神经根炎

[Meningoradiculitis caused by a spirochete (Borrelia burgdorferi) after arthropod bite].

作者信息

Dupuis M, Mertens C, Gonsette R E, Nuytten W, Bouffioux J, Dobbelaere F

出版信息

Rev Neurol (Paris). 1985;141(12):780-5.

PMID:3008294
Abstract

Eight cases of meningoradiculitis (Garin-Bujadoux-Bannwarth's syndrome) are presented; the first case followed an "unidentified insect" bite and erythema chronicum migrans, whereas the second and third cases were not preceded by any documented insect bite or erythema; they occurred during summer in 1984 and 1985 and were characterized by cranial or radicular neuritis, lymphocytic meningitis, positive serology by immunofluorescence against Borrelia Burgdorferi and a good response to Penicillin (20 000 000 U during 14 days I.V.). Five other cases were observed in the same area as the first and second cases (Walloon Brabant) during the preceding summers; in two, serological proof of Borrelia Burgdorferi infection was obtained retrospectively. Lyme disease and Garin-Bujadoux-Bannwarth syndrome are both tick-born spirochetosis, due to two slightly different subtypes of Borrelia Burgdorferi. Their early neurological manifestations differ mainly by focalised pain on the bitten region in Garin-Bujadoux-Bannwarth's syndromes. This could be due to direct aggression of the peripheral nerve in Garin-Bujadoux-Bannwarth syndrome.

摘要

本文报告了8例脑膜神经根炎(加林-布雅杜-班沃思综合征);第1例患者在被“不明昆虫”叮咬后出现慢性游走性红斑,而第2例和第3例患者在发病前没有任何已记录的昆虫叮咬或红斑;这两例分别发生于1984年和1985年夏季,其特征为颅神经或神经根神经炎、淋巴细胞性脑膜炎、抗伯氏疏螺旋体免疫荧光血清学检查呈阳性,且对青霉素(静脉注射2000万单位,持续14天)反应良好。在前几个夏季,在与第1例和第2例患者相同的地区(瓦隆布拉班特)又观察到另外5例;其中2例通过回顾性检查获得了伯氏疏螺旋体感染的血清学证据。莱姆病和加林-布雅杜-班沃思综合征均为蜱传螺旋体病,由伯氏疏螺旋体的两种略有不同的亚型引起。它们早期的神经表现主要区别在于加林-布雅杜-班沃思综合征患者被咬部位有局限性疼痛。这可能是由于加林-布雅杜-班沃思综合征中外周神经受到直接侵袭所致。

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