Dig Deeper – Review Articles

Pathology of Neurologic Lyme Disease from Infection to Inflammation

Abstract:

This review describes the current knowledge of the pathogenesis of acute Lyme neuroborreliosis (LNB), from invasion to inflammation of the central nervous system. Borrelia burgdorferi (B.b.) enters the host through a tick bite on the skin and may disseminate from there to secondary organs, including the central nervous system. To achieve this, B.b. first has to evade the hostile immune system. In a second step, the borrelia have to reach the central nervous system and cross the blood–brain barrier. Once in the cerebrospinal fluid (CSF), the spirochetes elicit an inflammatory response. We describe current knowledge about the infiltration of leukocytes into the CSF in LNB. In the final section, we discuss the mechanisms by which the spirochetal infection leads to the observed neural dysfunction. To conclude, we construct a stringent concept of the pathogenesis of LNB

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Clinical Presentation,Diagnosis, Therapy, and Advances with Neurologic Lyme Disease

Abstract:

Lyme neuroborreliosis (LNB), the neurological manifestation of systemic infection with the complex spirochaete Borrelia burgdorferi, can pose a challenge for practising neurologists. This Review is a summary of clinical presentation, diagnosis, and therapy, as well as of recent advances in our understanding of LNB. Many new insights have been gained through work in experimental models of the disease. An appreciation of the genetic heterogeneity of the causative pathogen has helped clinicians in their understanding of the diverse presentations of LNB.

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A controlled study of cognitive deficits in children with chronic Lyme disease

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Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed. (The Journal of Neuropsychiatry and Clinical Neurosciences 2001; 13:500–507)

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The Neuropsychiatric Manifestations of Lyme Borreliosis

Abstract:

Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed. (The Journal of Neuropsychiatry and Clinical Neurosciences 2001; 13:500–507)

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Underdiagnosis of Neuropsychiatric Lyme Disease in Children and Adults

Abstract:

Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi. Reported throughout the United States, the greatest incidence of Lyme disease occurs in certain areas, such as the Northeast, the upper Midwest, and the Pacific Coastal states. It has been dubbed The New Great Imitator because, like another spirochetal illness neurosyphilis–the original Great Imitator, Lyme disease has a vast array of multisystem manifestations, including neuropsychiatric ones. Failure to recognize Lyme disease early in its course can result in the development of a chronic illness that is only temporarily or partially responsive to antibiotic therapy. The goal of this article is to present the typical and atypical manifestations of Lyme disease in children and adults in order to help the clinician more rapidly unmask the correct diagnosis behind the puzzling presentations of some patients.

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Listing of Papers Supporting Chronic Lyme Disease 1977 to 2000

Abstract:

List of 65 papers reviewing Lyme disease from 1977 to 2000, with brief abstracts or notes.

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Diagnosis & Treatment: Issues Review

Abstract:

Since the identification of the causative organism more than 30 years ago, there remain questions about the diagnosis and treatment of Lyme disease. In this article, what is known about the disease will be reviewed, and approaches to the successful diagnosis and treatment of Lyme disease described.

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Tick attachment time required for Lyme disease infection

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Lyme borreliosis is increasing rapidly in many parts of the world and is the most commonly occurring vector-borne disease in Europe and the USA. The disease is transmitted by ticks of the genus Ixodes. They require a blood meal at each stage of their life cycle and feed on a wide variety of wild and domestic animals as well as birds and reptiles. Transmission to humans is incidental and can occur during visits to a vector habitat, when host mammals and their associated ticks migrate into the urban environment, or when companion animals bring ticks into areas of human habitation. It is frequently stated that the risk of infection is very low if the tick is removed within 24-48 hours, with some claims that there is no risk if an attached tick is removed within 24 hours or 48 hours.

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ILADS Guidelines: Diagnosis & Treatment Protocols 2014

Abstract:

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1-13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols.

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Deer and Tick Density Directly Related to Incidence of Lyme Disease in Connecticut Residential Community

Abstract:

White-tailed deer, serve as the primary host for the adult blacklegged tick (Ixodes scapularis), the vector for Lyme disease, human babesiosis, and human granulocytic anaplasmosis. Our objective was to evaluate the degree of association between deer density, tick abundance, and human cases of Lyme disease in one Connecticut community over a 13-yr period. We surveyed 90 to 98% of all permanent residents in the community six times from 1995 to 2008 to document residents exposure to tick-related disease and frequency and abundance of deer observations. After hunts were initiated, number and frequency of deer observations in the community were greatly reduced as were resident-reported cases of Lyme disease. Number of resident-reported cases of Lyme disease per 100 households was strongly correlated to deer density in the community. Reducing deer density to 5.1 deer per square kilometer resulted in a 76pct reduction in tick abundance, 70pct reduction in the entomological risk index, and 80pct reduction in resident-reported cases of Lyme disease in the community from before to after a hunt was initiated.

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Review of Acute and Chronic Pain in Lyme Disease

Abstract:

We performed a systematic review of the literature by searching the words -pain- and -Lyme disease- on PubMed. Our search criteria yielded 372 total references, including 280 English language references. The focus of this review is on the characteristics, possible etiologic mechanisms, and treatment of acute and chronic pain occurring in the setting of Lyme disease.

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Lyme Disease Health Care Costs

Abstract:

Note these articles are for private personal educational use only. They are not to be copied and distributed for any purpose except personal use according to US copyright law.

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Reference Articles: These articles are for personal educational use only. They are not to be copied or distributed. US copyright laws apply.

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