Scelsa S N, Lipton R B, Sander H, Herskovitz S
Department of Neurology, Montefiore Medical Center, Bronx, NY 10467, USA.
Headache. 1995 Mar;35(3):125-30. doi: 10.1111/j.1526-4610.1995.hed3503125.x.
We reviewed 49 patients consecutively hospitalized for neurologic Lyme disease to determine the frequency and characteristics of recent onset headaches in this group. All patients had positive serum Lyme ELISAs and other neurologic illness excluded. Recent-onset headache occurred in 26 of 49 patients (53%). Patients with headaches more commonly had central nervous system involvement (54% vs 19%, P < .05) and flu-like illness (58% vs 19%, P < .0005). Eight of 26 (31%) met criteria for meningitis or encephalitis with abnormal CSF examinations. All 8 had focal findings (6), cognitive dysfunction (1), or both (1). The remaining 18 patients had recent-onset headaches resembling migraine (9), tension-type headache (5), or neither (4). Antibiotic treatment resulted in complete headache resolution in 11 of 14 patients with available follow-up data. Based on these findings, we conclude that recent-onset headaches are common in patients hospitalized with Lyme disease. Of those with meningitis or encephalitis requiring intravenous antibiotics, all had focal neurologic findings or cognitive abnormalities, not just headaches.
我们连续回顾了49例因神经型莱姆病住院的患者，以确定该组近期发作头痛的频率和特征。所有患者血清莱姆酶联免疫吸附测定（ELISA）均为阳性，且排除了其他神经系统疾病。49例患者中有26例（53%）出现近期发作的头痛。有头痛的患者更常出现中枢神经系统受累（54% 对19%，P < 0.05）和流感样疾病（58% 对19%，P < 0.0005）。26例中有8例（31%）脑脊液检查异常，符合脑膜炎或脑炎标准。所有8例均有局灶性表现（6例）、认知功能障碍（1例）或两者兼有（1例）。其余18例患者近期发作的头痛类似偏头痛（9例）、紧张型头痛（5例）或两者都不像（4例）。在14例有随访数据的患者中，抗生素治疗使11例患者的头痛完全缓解。基于这些发现，我们得出结论，近期发作的头痛在因莱姆病住院的患者中很常见。在那些需要静脉使用抗生素治疗的脑膜炎或脑炎患者中，所有人都有局灶性神经学表现或认知异常，而不仅仅是头痛。
