A contribution
to the current in post-borrelia syndrome
Pícha D.1, Moravcová L.1, Lásiková Š.1, Patakiová E.2, Roháčová H.2, Marešová V.1
1UK, 2. LF v Praze, 1. infekční klinika 2FN Bulovka, Infekční klinika, Praha |
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Summary:
The paper concerns with subjective complaints in patients after lege-artis treated neuroborreliosis
(NB). This retrospective study included 88 patients, who responded to a questionnaire regarding
further development of their disease. At the time of our follow-up, the patients had clinical disease
compatible with NB, together with a positive antibody index CSF/serum and/or positive PCR in the CSF.
The most common clinical manifestation of NB was Bannwarth syndrome (26 patients) and mild
meningitis or meningo-encephalitis (34 patients), 8 patients had meningoencephaloradiculitis, 10 had
meningomononeuritis (n. VIIth lesion). Five patients had clinical manifestations of artralgias with
headache. Subjective symptoms disappeared within 6 months after treatment in 42 patients (49 %),
within 1 year in another 10 (8%), in 3 patients, the problems persisted for up to 3 years (3 %) and in 33
(37%) the problems lasted more than 3 years. Objective neurological findings have normalized immediately
after therapy in 49 patients (56%), very mild neurological changes were found in 24 (27%) of
those followed-up, in 14 patients (17%), the findings were more extensive. Six months after therapy,
neurological findings were normalized in 72 patients (82%) and 11 (13%) had very mild residual findings.
In five patients (5%), more significant changes persisted. The most frequent subjective complaints in
patients after therapy were headache (65, 74%), psychic complaints (tension, depression, fatigue – 61,
69%), joint pain (33, 38%) and muscle pain (20, 23%). Despite the high percentage of patients having
subjective complaints in the subsequent course of the disease, only 8 patients sought further medical
help for borreliosis and none of those underwent repeat treatment with antibiotics. Based upon these
results, post-borrelia syndrome can be expected in a subset of patients.
Key words:
Lyme borreliosis, neuroborreliosis, post-borrelia syndrome
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