Inflammatory brain changes in Lyme borreliosis: A report on three patients and review of literature (original) (raw)

Journal Article

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1

Departments of Internal MedicineTurku University Central Hospital

Turku, Finland

5

Department of Medical Microbiology, Turku University

Turku, Finland

7

Turku Immunology Centre

Turku, Finland

Correspondence to: J. Oksi, Turku University, Department of Medical Microbiology, Kiinamyllynkatu 13, FIN-20520 Turku, Finland

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2

Departments of Pathology, Turku University Central Hospital

Turku, Finland

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3

Departments of Neurology, Turku University Central Hospital

Turku, Finland

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2

Departments of Pathology, Turku University Central Hospital

Turku, Finland

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4

Departments of Radiology, Turku University Central Hospital

Turku, Finland

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Departments of Internal MedicineTurku University Central Hospital

Turku, Finland

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6

National Public Health Institute, Department in Turku

Turku, Finland

7

Turku Immunology Centre

Turku, Finland

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Revision received:

04 June 1996

Published:

01 December 1996

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J. Oksi, H. Kalimo, R. J. Marttila, M. Marjamaki, P. Sonninen, J. Nikoskelainen, M. K. Viljanen, Inflammatory brain changes in Lyme borreliosis: A report on three patients and review of literature, Brain, Volume 119, Issue 6, December 1996, Pages 2143–2154, https://doi.org/10.1093/brain/119.6.2143
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Abstract

Despite a rapid increase in the number of patients with Lyme neuroborreliosis (LNB), its neuropathological aspects are poorly understood. The objective of this study was evaluation of neuropathological, microbiological, and magnetic resonance imaging (MRI) findings in three patients with the Borrelia burgdorferi infection and neurological disease from whom brain tissue specimens were available. Perivascular or vasculitic lymphocytic inflammation was detected in all specimens. Large areas of demyelination in periventricular white matter were detected histologically and by MRI in one patient. The disease had a fatal outcome in this patient. Brain MRI suggested malignancies in two patients before histopathological studies were carried out. One of these two patients was a child with sudden hemiparesis. Another was a 40-year-old man presenting with epileptic seizures and MRI-detected multifocal lesions, which disappeared after repeated courses of antibiotics. We conclude that cerebral lymphocytic vasculitis and multifocal encephalitis may be associated with B. burgdorferi infection. The presence of B. burgdorferi DNA in tissue samples from areas with inflammatory changes indicates that direct invasion of B. burgdorferi may be the pathogenetic mechanism for focal encephalitis in LNB.

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Topic:

• antibiotics
• magnetic resonance imaging
• lyme disease
• epilepsy
• encephalitis
• nervous system disorders
• inflammation
• vasculitis
• cancer
• child
• dna
• fatal outcome
• lyme neuroborreliosis
• lymphocytes
• infections
• brain
• focal encephalitis
• hemiparesis
• brain mri
• brain tissue
• white matter
• demyelination
• histopathology tests
• tissue specimen

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