Krishnamurthy K B, Liu G T, Logigian E L
Division of Neurology, Brigham and Women's Hospital, Boston, MA 02115.
Muscle Nerve. 1993 Nov;16(11):1261-4. doi: 10.1002/mus.880161118.
A 53-year-old man developed multifocal radicular pain. The diagnosis of Lyme neuroborreliosis was delayed until bifacial paresis and right lower abdominal wall weakness developed, prompting further evaluation. Cerebrospinal fluid (CSF) examination showed aseptic meningitis. Antibodies directed against Borrelia burgdorferi were present in the serum; higher titers were present in the CSF, indicating local antibody production. Electrophysiologic studies showed both an axonal polyradiculopathy as well as demyelinative facial palsy. Ceftriaxone therapy led to marked improvement in pain and facial palsies.
一名53岁男性出现多灶性神经根性疼痛。莱姆病性神经疏螺旋体病的诊断延迟，直至出现双侧面神经麻痹和右下腹壁无力，才促使进一步评估。脑脊液（CSF）检查显示为无菌性脑膜炎。血清中存在针对伯氏疏螺旋体的抗体；脑脊液中的滴度更高，表明存在局部抗体产生。电生理研究显示既有轴索性多神经根病，也有脱髓鞘性面神经麻痹。头孢曲松治疗使疼痛和面神经麻痹明显改善。
