Naslov
Bannwarth's syndrome – a case report

Autori
Petković, Dobrinka ; Vuković, Borislav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
MIND & BRAIN. 60th INTERNATIONAL NEUROPSYCHIATRIC CONGRESS. ABSTRACT BOOK 2021 / - , 2021, 76-76

Skup
60. Međunarodni neuropsihijatrijski kongres (MIND & BRAIN)

Mjesto i datum
Pula, Hrvatska, 27.05.2021. - 30.05.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Bannwarth's syndrome ; case report

Sažetak
Introduction/Objectives: Lyme disease is a tick- borne transmitted multisystem inflammatory disease caused by Borrelia burgdorferi sensu lato. Neurological manifestations of central and peripheral nervous system are termed Lyme neuroborreliosis (LNB) and may occur in early and late disseminated stages disease. Bannwarth's syndrome (BWS) is a typical manifestation of early LNB characterised by lymphocytic pleocytosis and painful radiculoneuritis, often associated with cranial nerve involvement and sometime with peripheral paresis. Objectives: Review of clinical presentation, laboratory data, treatment and outcome of patient with BWS. Case report: A 57-year-old man presented with a 5- day history of left-sided neck-arm pain and muscle weakness and paresthesias of the left hand and forearm. Four weeks prior, the patient observed a concentric redness of the skin of the left elbow and chest. A clinical examination revealed erythema chronicum migrans (ECM) and lesion of the left spinal nerve roots (C8-T1). He had a moderate motor weakness of the left hand, flexion of the left elbow and abduction of the fifth finger were moderately impaired, and hypoesthesia in the innervation region of the left ulnar nerve was detected. BWS diagnosis was based on laboratory, physical and neurological examinations. Hematological-biochemical tests were within reference range, MRI brain scan, electrocadiography and encephalography gave normal results, while electromyography showed abnomal spontaneous activity in the form of positive sharp waves and fibrillations in C8-T1 innervated muscles. Cerebrospinal fluid (CSF) analysis confirmed lymphocytic pleocytosis (57 WBCs/mcL, 91% lymphocytes). CSF cultures remained negative. The serology test (CLIA) confirmed Borrelia burgdorferi specific IgM 56 (reference range 22- 18) AU/mL and IgG >240 (reference range 15-10) AU/mL antibodies in serum. Western blot IgM and IgG was positive. CSF analysis (CLIA) confirmed the intrathecal syntesis Borrelia-specific IgM 20, 9 (reference range 3, 5- 2, 5) AU/mL and IgG >240 (reference range 5, 5-4, 5 ) AU/mL antibodies. Patient was treated with ceftriaxone iv 2 g/q24h for 21 days, and thereafter with doxycycline po 100 mg q12h for 14 days. At the six months follow-up the patient indicated incomplete recovery of neurological deficit. Conclusions: We presented a case of BWS manifested with ECM, painful radiculoneuritis of the lower trunk of the brachialis plexus and lymphocytic pleocytosis. Treatment started early on the fifth day of illness and the patient showed partial neurological improvement six months after the onset of disease. Early diagnosis of LNB and long–term administration of antibiotics is important in the prevention of late complications such as encephalomyelitis, cerebral vasculitis, peripheral and autonomic neuropathy, psychiatric disturbances, etc.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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