Gérard P, Canaple S, Rosa A
Service de Neurologie, CHU Amiens.
Rev Neurol (Paris). 1996 Jun-Jul;152(6-7):476-8.
A 65 old year woman was admitted to the hospital for a low back pain, a fever and an elevated sedimentation rate. Four months later she noted a progressive visual loss first affected the right eye (visual acuity: 6/10) and then the left (visual acuity : 6/10). Fundus examination showed a bilateral papilledema. CT Scan and MRI were normal. A lumbar puncture disclosed a lymphocytic pleocytosis (68 leukocytes/mm3), an increase in protein level (1,9 g/l) and oligoclonal bands. A serologic test for B. Burgdorferi was positive both in blood (1/64 degrees) and in cerebrospinal fluid (> or = 1/128). The patient was treated with intravenous ceftriaxone 2 g daily for 2 weeks. Fifteen days later the low back pain had disappeared and the CSF cellular count had decreased to 20 leukocytes/mm3. Seven months later, CSF was normal (2 leukocytes/mm3, protein level: 0.65 g/l.); Titer against B. Burgdorferi had improved to 1/160 in serum and 1/16 in CSF; visual acuity had improved to 8/10 on left, and was the same on right.
一位65岁女性因腰痛、发热和血沉升高入院。四个月后，她发现视力逐渐下降，首先影响右眼（视力：6/10），然后是左眼（视力：6/10）。眼底检查显示双侧视乳头水肿。CT扫描和MRI均正常。腰椎穿刺显示淋巴细胞增多（68个白细胞/mm³）、蛋白水平升高（1.9 g/l）和寡克隆带。伯氏疏螺旋体血清学检测在血液中（1/64滴度）和脑脊液中（≥1/128）均为阳性。患者接受每日2 g静脉注射头孢曲松治疗2周。15天后，腰痛消失，脑脊液细胞计数降至20个白细胞/mm³。七个月后，脑脊液恢复正常（2个白细胞/mm³，蛋白水平：0.65 g/l）；血清中抗伯氏疏螺旋体滴度提高到1/160，脑脊液中提高到1/16；左眼视力提高到8/10，右眼视力相同。
