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CABI Book Chapter

Lyme disease: an evidence-based approach.

Book cover for Lyme disease: an evidence-based approach.

Description

This second edition provides up-to-date evidence-based research and covers the significant advances in our understanding of the disorders referred to as Lyme disease or Lyme borreliosis. Consisting of 17 chapters, this book explores the causative organism, its requisite ecosystem, disease epidemiology, host-Borrelia interactions, diagnostic testing, clinical manifestations, therapeutic options, th...

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Chapter 9 (Page no: 139)

Medically unexplained symptoms and Lyme neuroborreliosis - not the same: a study in an endemic area of Norway.

After reports that the Hospital of Southern Norway has experienced a rise in referrals for suspected Lyme neuroborreliosis (LNB), an investigation was carried out to examine these patients' symptoms and final diagnoses to learn more about the presentation of LNB in Norway. The medical records of all patients who were referred for lumbar puncture for possible LNB at the hospital in 2013, were retrospectively analysed. The patients were divided into 2 groups based on their symptoms: patients with symptoms typical for LNB, and patients with non-specific symptoms (e.g. fatigue, dizziness, difficulty concentrating, non-specific paresthesia and headaches). The clinical presentations of patients diagnosed with LNB were compared to those who did not meet the criteria for LNB diagnosis. Out of the 140 patients referred to the hospital with possible LNB, 110 (79%) did not have symptoms typical of LNB, including one who was diagnosed with possible LNB. Of the 30 patients with typical symptoms of LNB, 6 were diagnosed with definite LNB. The most common symptom of LNB was peripheral facial nerve palsy. Of the 140 patients, 66% had positive serology for anti-Borrelia antibodies. It is concluded that LNB is an unlikely explanation for long-lasting subjective health complaints, even in individuals with positive Borrelia serology. People with new onset of peripheral cranial nerve palsy should be examined with a lumbar puncture for LNB in an endemic area.

Other chapters from this book

Chapter: 1 (Page no: 1) Ticks: the vectors of Lyme disease. Author(s): Smith, R. P.
Chapter: 2 (Page no: 29) Biology of the Lyme disease agents: a selective survey of clinical and epidemiologic relevance. Author(s): Barbour, A. G.
Chapter: 3 (Page no: 45) Borreliella: interactions with the host immune system. Author(s): Sperber, K. Dattwyler, R. J.
Chapter: 4 (Page no: 58) Diagnostic testing for Lyme disease. Author(s): Auwaerter, P. G.
Chapter: 5 (Page no: 76) Global epidemiology of Borreliella burgdorferi infections. Author(s): Mead, P. S.
Chapter: 6 (Page no: 93) Antibiotic therapy for infection caused by Borrelia burgdorferi sensu lato. Author(s): Wormser, G. P.
Chapter: 7 (Page no: 105) Lyme borreliosis: the European perspective. Author(s): Strle, F. Stanek, G. Strle, K.
Chapter: 8 (Page no: 124) Lyme neuroborreliosis: a European perspective. Author(s): Dersch, R.
Chapter: 10 (Page no: 142) Erythema migrans. Author(s): Nadelman, R. B. Hu, L.
Chapter: 11 (Page no: 168) Lyme carditis. Author(s): Salik, J. R. Dudzinski, D. M.
Chapter: 12 (Page no: 180) The musculoskeletal manifestations of Lyme disease (infection with Borrelia burgdorferi). Author(s): Sigal, L. H.
Chapter: 13 (Page no: 202) Nervous system involvement. Author(s): Halperin, J. J.
Chapter: 14 (Page no: 216) Lyme disease in children. Author(s): Shapiro, E. D.
Chapter: 15 (Page no: 227) The psychology of 'post-Lyme disease syndrome' and 'not Lyme'. Author(s): Hassett, A. L. Sigal, L. H.
Chapter: 16 (Page no: 247) Chronic Lyme disease. Author(s): Marques, A.
Chapter: 17 (Page no: 262) Lyme disease: the great controversy. Author(s): Halperin, J. J. Baker, P. Wormser, G. P.

Chapter details

  • Author Affiliation
  • Faculty of Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway.
  • Year of Publication
  • 2018
  • ISBN
  • 9781786392077
  • Record Number
  • 20183240051