Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations
Abstract Background Lyme neuroborreliosis is the disseminated stage of an infectious disease caused by Borrelia burgdorferi (BB). The most prevalent clinical manifestations include meningoradiculitis and involvement of the cranial nerves with lymphocytic meningitis. Facial nerve is the most frequent...
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BMC
2025-02-01
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| Online Access: | https://doi.org/10.1186/s12879-025-10588-0 |
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| author | Dominica Hudasch Franz Felix Konen Nora Möhn Lea Grote-Levi Ulrich Wurster Gabriel Welte Josef Conzen Nima Mahmoudi Thomas Skripuletz Philipp Schwenkenbecher |
| author_facet | Dominica Hudasch Franz Felix Konen Nora Möhn Lea Grote-Levi Ulrich Wurster Gabriel Welte Josef Conzen Nima Mahmoudi Thomas Skripuletz Philipp Schwenkenbecher |
| author_sort | Dominica Hudasch |
| collection | DOAJ |
| description | Abstract Background Lyme neuroborreliosis is the disseminated stage of an infectious disease caused by Borrelia burgdorferi (BB). The most prevalent clinical manifestations include meningoradiculitis and involvement of the cranial nerves with lymphocytic meningitis. Facial nerve is the most frequently affected cranial nerve. Neuroborreliosis presenting as encephalitis is only scarcely described in the literature. Methods Medical records of patients between 2014 and 2024 were screened and reviewed for neuroborreliosis. Patients were only included if they met the diagnostic criteria for definite neuroborreliosis. Results A total of seven patients with neuroborreliosis induced encephalitis were identified. The median age was 72 years, and except for one man, all patients were women. Clinical manifestations ranged from cognitive impairments resembling primary dementia to movement disorders mimicking Parkinson's disease, tremor, and epileptic seizures. In 5/7 patients (71%) they occurred between August to September. In addition to central nervous system involvement, all patients exhibited characteristic features of neuroborreliosis like painful meningoradiculitis or peripheral facial palsy. An elevated cell count in cerebrospinal fluid (CSF), positive oligoclonal bands, and blood-CSF barrier dysfunction indicated by an elevated albumin quotient (QAlb) was found in all patients. Advanced age, in which immunosenescence can occur, might contribute in developing encephalitis caused by neuroborreliosis in the patients of this cohort. Conclusion Neuroborreliosis can present with symptoms that mimic various neurological disorders, such as dementia, movement disorders, and epilepsy. Radiculitis, peripheral facial palsy or meningitis are an additional hint for this infectious disease. Analysis of CSF, which includes testing for intrathecally produced BB antibodies, is crucial for the diagnosis. |
| format | Article |
| id | doaj-art-b201e546341c4d2b91db73816067ea59 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-b201e546341c4d2b91db73816067ea592025-02-09T12:14:43ZengBMCBMC Infectious Diseases1471-23342025-02-0125111010.1186/s12879-025-10588-0Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestationsDominica Hudasch0Franz Felix Konen1Nora Möhn2Lea Grote-Levi3Ulrich Wurster4Gabriel Welte5Josef Conzen6Nima Mahmoudi7Thomas Skripuletz8Philipp Schwenkenbecher9Department of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Nordstadt Hospital HannoverDepartment of Radiology / Neuroradiology, Nordstadt Hospital HannoverDepartment of Diagnostic and Interventional Neuroradiology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolAbstract Background Lyme neuroborreliosis is the disseminated stage of an infectious disease caused by Borrelia burgdorferi (BB). The most prevalent clinical manifestations include meningoradiculitis and involvement of the cranial nerves with lymphocytic meningitis. Facial nerve is the most frequently affected cranial nerve. Neuroborreliosis presenting as encephalitis is only scarcely described in the literature. Methods Medical records of patients between 2014 and 2024 were screened and reviewed for neuroborreliosis. Patients were only included if they met the diagnostic criteria for definite neuroborreliosis. Results A total of seven patients with neuroborreliosis induced encephalitis were identified. The median age was 72 years, and except for one man, all patients were women. Clinical manifestations ranged from cognitive impairments resembling primary dementia to movement disorders mimicking Parkinson's disease, tremor, and epileptic seizures. In 5/7 patients (71%) they occurred between August to September. In addition to central nervous system involvement, all patients exhibited characteristic features of neuroborreliosis like painful meningoradiculitis or peripheral facial palsy. An elevated cell count in cerebrospinal fluid (CSF), positive oligoclonal bands, and blood-CSF barrier dysfunction indicated by an elevated albumin quotient (QAlb) was found in all patients. Advanced age, in which immunosenescence can occur, might contribute in developing encephalitis caused by neuroborreliosis in the patients of this cohort. Conclusion Neuroborreliosis can present with symptoms that mimic various neurological disorders, such as dementia, movement disorders, and epilepsy. Radiculitis, peripheral facial palsy or meningitis are an additional hint for this infectious disease. Analysis of CSF, which includes testing for intrathecally produced BB antibodies, is crucial for the diagnosis.https://doi.org/10.1186/s12879-025-10588-0Lyme borreliosisEncephalitisNeuroborreliosisCSFCNS infection |
| spellingShingle | Dominica Hudasch Franz Felix Konen Nora Möhn Lea Grote-Levi Ulrich Wurster Gabriel Welte Josef Conzen Nima Mahmoudi Thomas Skripuletz Philipp Schwenkenbecher Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations BMC Infectious Diseases Lyme borreliosis Encephalitis Neuroborreliosis CSF CNS infection |
| title | Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations |
| title_full | Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations |
| title_fullStr | Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations |
| title_full_unstemmed | Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations |
| title_short | Neuroborreliosis with encephalitis: a broad spectrum of clinical manifestations |
| title_sort | neuroborreliosis with encephalitis a broad spectrum of clinical manifestations |
| topic | Lyme borreliosis Encephalitis Neuroborreliosis CSF CNS infection |
| url | https://doi.org/10.1186/s12879-025-10588-0 |
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