Optic Neuritis in Acute Neuroborreliosis (Lyme Disease) in the U.S.-Mexican Border: Case Report  

作　　者：Ihtesham A. Qureshi Michael F. Maldonado Gustavo J. Rodriguez Salvador Cruz-Flores Alberto Maud Ihtesham A. Qureshi;Michael F. Maldonado;Gustavo J. Rodriguez;Salvador Cruz-Flores;Alberto Maud(Neurology Department, Texas Tech University Health Sciences Center, El Paso, USA;Ophthalmology Department, Texas Tech University Health Sciences Center, El Paso, USA)

机构地区：[1]Neurology Department, Texas Tech University Health Sciences Center, El Paso, USA [2]Ophthalmology Department, Texas Tech University Health Sciences Center, El Paso, USA

出　　处：《World Journal of Neuroscience》2016年第2期126-130,共5页神经科学国际期刊（英文）

摘　　要：Objective: We describe a patient diagnosed with acute neuroborreliosis presenting with anterior optic neuritis (papillitis) in a non-endemic region. Case Presentation: A 43-year-old previously healthy right handed man admitted due to an insidious onset of severe headache and spells of ascending paresthesias from his right foot into his right arm and face followed by speech arrest and clumsiness of his right hand. His neurologic exam was significant for somnolence, nuchal rigidity and Kernig and Brudzinski signs were present. MRI of the brain with gadolinium showed diffuse hyperintense signal involving the supra and infratentorial cortical sulci, with associated faint diffuse leptomeningeal enhancement, consistent most likely with diffuse leptomeningoencephalitis. EEG: normal. CSF VDRL was negative. Dilated fundus exam revealed mild optic nerve edema more significant to the left than to the right eye, confirmed and measured by spectral domain OCT (Optical Coherence Tomography). There was an evidence of posterior uveitis with an early vitreous hemorrhage superficial to the left optic nerve. Lyme disease serum antibody (IgM) Immunoblotting was positive in 2 bands confirming the diagnosis of neuroborreliosis. Conclusion: Optic nerve involvement in Lyme disease is an uncommon complication that should be confirmed by specific diagnostic criteria to establish its causal relation.Objective: We describe a patient diagnosed with acute neuroborreliosis presenting with anterior optic neuritis (papillitis) in a non-endemic region. Case Presentation: A 43-year-old previously healthy right handed man admitted due to an insidious onset of severe headache and spells of ascending paresthesias from his right foot into his right arm and face followed by speech arrest and clumsiness of his right hand. His neurologic exam was significant for somnolence, nuchal rigidity and Kernig and Brudzinski signs were present. MRI of the brain with gadolinium showed diffuse hyperintense signal involving the supra and infratentorial cortical sulci, with associated faint diffuse leptomeningeal enhancement, consistent most likely with diffuse leptomeningoencephalitis. EEG: normal. CSF VDRL was negative. Dilated fundus exam revealed mild optic nerve edema more significant to the left than to the right eye, confirmed and measured by spectral domain OCT (Optical Coherence Tomography). There was an evidence of posterior uveitis with an early vitreous hemorrhage superficial to the left optic nerve. Lyme disease serum antibody (IgM) Immunoblotting was positive in 2 bands confirming the diagnosis of neuroborreliosis. Conclusion: Optic nerve involvement in Lyme disease is an uncommon complication that should be confirmed by specific diagnostic criteria to establish its causal relation.

关 键 词：Optic Neuritis Lyme Disease Non-Endemic Papillitis 

分 类 号：R73[医药卫生—肿瘤]