Lyme Disease: Stroke Risk And Complications

Lyme disease is a tick-borne illness that can, in rare cases, cause a stroke. This condition, known as Lyme neuroborreliosis (LNB), involves the nervous system and can lead to cerebrovascular complications such as ischemic stroke, transient ischemic attack (TIA), and very rarely, intracranial hemorrhage. While Lyme disease is the most common tick-borne disease in Europe and North America, LNB is more commonly reported in Europe. Prompt diagnosis and treatment with antibiotics are crucial to prevent long-term neurological deficits and potential death.

Lyme neuroborreliosis (LNB) can cause strokes

Lyme neuroborreliosis (LNB) is a disease caused by the spirochete Borrelia burgdorferi that affects the nervous system. Although it usually manifests as lymphocytic meningoradiculitis, in rare cases, it can lead to cerebrovascular complications such as strokes.

Ischemic stroke due to Lyme disease is considered rare, but several cases have been reported where LNB has resulted in strokes. For example, an 83-year-old man was admitted to the emergency room with right-sided weakness and speech difficulties. He was diagnosed with LNB and treated with antibiotics, but he was left with partial paralysis of his right arm. In another case, a 76-year-old woman presented with acute ischemic strokes and unique radiological findings. She was also found to have LNB and LNB-associated vasculopathy.

A systematic review of the literature identified 88 patients with LNB-associated cerebrovascular complications, with a median age of 46 years. The most common cerebrovascular manifestation was ischemic stroke (76.1%), followed by transient ischemic attack (11.4%). The review also found that LNB-induced vasculitis is highly responsive to appropriate antimicrobial treatment, with 75.3% of patients achieving a complete response. However, permanent neurological deficits can occur, especially if antibiotic treatment is delayed.

Therefore, LNB-associated vasculopathy and the possibility of stroke should be considered in patients presenting with acute ischemic strokes, especially in those who live in or have travelled from areas with a high prevalence of tick-borne diseases. A detailed medical history, including any history of tick bites or Lyme disease symptoms, is crucial for accurate diagnosis and timely treatment.

LNB-associated vasculopathy should be considered in stroke patients with no cardiovascular risk factors

Lyme disease is a tick-borne disease caused by the spirochete Borrelia burgdorferi, which can involve the nervous system. Lyme neuroborreliosis (LNB) is a rare complication of Lyme disease, which can lead to cerebrovascular complications such as LNB-associated vasculopathy.

Lyme neuroborreliosis vasculopathy should be considered in stroke patients with no cardiovascular risk factors, especially in those who live in or have travelled from areas with a high prevalence of tick-borne diseases. This is because LNB-associated vasculopathy can present as acute ischemic strokes with an embolic pattern of undetermined aetiology.

A systematic review of the literature on LNB-associated vasculopathy and stroke found that the most common cerebrovascular manifestation of LNB was ischemic stroke (76.1%), followed by transient ischemic attack (11.4%). The posterior circulation was affected alone in 37.8% of patients, the anterior circulation in 24.4% of patients, and in 37.8% of cases, posterior and anterior circulations were affected simultaneously. The most common affected vessels were the middle cerebral artery, basilar artery, and anterior cerebral artery.

The review also found that LNB-associated vasculopathy should be considered in patients with vasculitis and multiple ischemic lesions of unknown origin, especially in those living in endemic areas. The lack of awareness of this manifestation of LNB might result in a delay in diagnosis, which could lead to the patient's death.

LNB is caused by spirochete Borrelia burgdorferi, which involves the nervous system

Lyme neuroborreliosis (LNB) is caused by the spirochete Borrelia burgdorferi, which involves the nervous system. LNB can affect both the central and peripheral nervous systems.

The spirochete Borrelia burgdorferi is transmitted by Ixodes spp ticks. The most common symptoms of Lyme disease include the presence of a skin rash at the tick bite site, as well as fever, headache, and fatigue. If left untreated, Lyme disease can persist and the patient may develop neurological, cardiac, chronic skin, or articular symptoms.

Lyme neuroborreliosis (LNB) is a form of Lyme disease that affects the nervous system. LNB can manifest as meningitis, cranial neuritis, radiculoneuritis, parenchymal inflammation of the brain or spinal cord, peripheral neuropathy, and/or encephalopathy. LNB is caused by the Borrelia burgdorferi sensu lato complex, which includes the species: B. garinii, B. afzelii (common in Europe), and B. burgdorferi sensu stricto (common in North America).

In an earlier study, histopathological evaluation showed varying degrees of necrosis in the sensory ganglia of rhesus macaques that were infected with B. burgdorferi. In an in vivo experiment, rhesus macaques inoculated with B. burgdorferi into the cisterna magna showed increased levels of IL-6, IL-8, CCL2, and CXCL13, accompanied by a monocytic/lymphocytic pleocytosis. This inflammatory response was concomitant with histopathological changes consistent with acute neurologic Lyme disease, such as leptomeningitis and radiculitis.

The mechanisms underlying the pathogenesis of peripheral LNB are not clearly understood. However, it is hypothesized that B. burgdorferi induces inflammatory mediators in glial and neuronal cells, and that this inflammatory context precipitates glial and neuronal apoptosis.

In this model, B. burgdorferi induced an inflammatory response and neuronal apoptosis of the dorsal root ganglia (DRG). These pathophysiological processes could contribute to peripheral neuropathy in LNB.

LNB usually manifests as lymphocytic meningoradiculitis

Lyme neuroborreliosis (LNB) is a disease caused by the spirochete bacterium Borrelia burgdorferi, which is transmitted by ticks. It involves the nervous system and usually manifests as lymphocytic meningoradiculitis, also known as Bannwarth syndrome. This disease is characterised by intense nerve pain radiating from the spine, particularly in the lumbar and cervical regions, and sometimes extending to the extremities.

The symptoms of LNB can include:

• Facial paralysis
• Abducens palsy
• Anorexia
• Tiredness
• Headache
• Double vision
• Paraesthesia
• Erythema migrans

LNB is treated with antibiotics, typically oral doxycycline or IV ceftriaxone for 14-21 days.

In rare cases, LNB can lead to cerebrovascular complications such as stroke.

LNB can also lead to cerebrovascular complications

Lyme neuroborreliosis (LNB) is a disease caused by the spirochete Borrelia burgdorferi, which affects the nervous system. While it usually manifests as lymphocytic meningoradiculitis, in rare cases, it can also lead to cerebrovascular complications.

Cerebral vasculitis and stroke due to LNB are rare but important to consider, especially in patients from areas with a high prevalence of tick-borne diseases or those without cardiovascular risk factors but exhibiting stroke-like symptoms of unknown cause. The most common cerebrovascular manifestation of LNB is ischemic stroke, which occurred in 76.1% of cases in one review. The median interval from the onset of symptoms suggesting Lyme disease to the first symptoms of cerebrovascular manifestations of LNB was 3.5 months.

LNB-associated vasculopathy should be considered in patients presenting with acute ischemic strokes with an embolic pattern of undetermined etiology, especially those from areas with a high prevalence of tick-borne diseases. LNB can lead to long-term sequelae, and even after standard pharmacological treatment, permanent neurological deficits may occur.

A case study of an 83-year-old man with LNB-associated cerebrovascular complications highlights the importance of gathering a complete patient history and performing adequate ancillary tests. The patient presented with right-sided weakness and speech difficulties, and further testing revealed a positive lupus anticoagulant. Antibiotic treatment with intravenous Ceftriaxone was administered for 14 days, and the patient showed slow improvement.

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