Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection with the tick-borne Borrelia burgdorferi can lead to a variety of neurologic symptoms, the most frequent being a radicular pain syndrome due to meningitis. General symptoms such as asthenia or headache are also frequent, however, and serious neurologic complications such as dementia or spastic paresis may occur. At an early stage, Borrelia infections can be easily treated with antibiotics, which makes it important to recognize the symptoms and make the correct diagnosis. A common feature of borreliosis is facial palsy, and in the article is described the case of a 14 year-old boy with borreliosis and bilateral facial palsy. The frequency of facial palsy from borreliosis is probably high. The authors discuss the indications for performing lumber puncture in patients with apparent idiopathic facial palsy (Bell's palsy).
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PMID:[Peripheral facial paresis as a symptom of Borrelia burgdorferi infection]. 155 45

Meningopolyradiculitis (Garin-Bujadoux syndrome, Bannwarth syndrome) is the second stage of Lyme disease, a tick-borne Borrelia infection. Almost 60% of these patients develop an acute peripheral facial paresis. The disease can be differentiated from Bell's palsy only by finding the specific Borrelia antibodies in serum and CSF. Other cranial nerve lesions can be found besides facial paresis. The follow-up of seven Borrelia-infected patients is described: one showed bilateral, the others unilateral, facial paresis. High dosage of penicillin or tetracycline for 10-14 days is the appropriate therapy. The prognosis of facial paresis in tick-borne Borrelia infection is considered to be good. All our patients showed complete recovery of motor nerve function.
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PMID:[Prognosis of peripheral facial paralysis in Lyme borreliosis (Garin-Bujadoux, Bannwarth meningopolyradiculitis)]. 272 77

Between September 1986 and November 1988, 17 patients were hospitalized and treated for neuro-borreliosis. Ten of them had been admitted with suspected lumbar or cervical root or compression syndrome. Only four patients recalled a tick bite, only three an erythema migrans. Uni- or bilateral facial paresis was a prominent feature in six patients. Three of 14 patients had no IgG antibodies against Borrelia, either in serum or cerebrospinal fluid at the initial examination, two had positive titres in serum only. Despite antibiotic treatment (usually 10 mega U penicillin three times daily) six patients had a recurrence by April, 1989, treated with penicillin again or with twice daily 100 mg doxycycline or 2 g ceftriaxon. In four of them a residual painful polyneuropathy remains.
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PMID:[Neuro-borreliosis or intervertebral disk prolapse?]. 280 90

Lymphocytic meningopolyradiculitis (Bannwarths' syndrome) is a tick-borne Borrelia infection of man. About 60 per cent of such patients exhibit a peripheral facial paresis whose characteristics are clinically not distinguishable from Bell's paresis. Of major importance for the diagnosis, besides the radicular pain that nearly always prevails, are particularly further motoric deficits, a previous erythema migrans and remembered thick bites. A tentative diagnosis can be verified by liquor examination which reveals a characteristic pattern of protein distribution and lymphocytic pleocytosis. Penicillin in high doses is the therapy of choice.
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PMID:[Differential diagnosis of idiopathic facial paralysis: Bannwarth meningopolyradiculitis]. 371 Aug 42

Isolation of Borrelia burgdorferi from the CSF is relatively rare. The present report describes the first three isolations in Switzerland. Clinically, our first observation confirmed the frequent association of B. burgdorferi with peripheral facial paresis in children. The other two cases illustrate the variety of symptoms in neuro-borreliosis. In the first case the culture was positive after 6 weeks. The results of serologic tests (indirect immunofluorescence and ELISA) for detection of antibodies against B. burgdorferi were negative or non-significant in this child's serum. On the other hand, specific antibodies (IgG) were detected in the serum by western blot. Culture of the second CSF already showed Borrelia growth after 10 days. Immunofluorescence revealed high antibody titers (1/256) against B. burgdorferi in this patient's serum. IgG showed a weakly positive reaction in western blot. The reliability of this result was confirmed by isolation of Borrelia. In neither of the two CSF could intrathecal synthesis of specific antibodies be demonstrated. In the third case, however, immunofluorescence showed IgG antibody titers of 1/128 in the CSF and 1/512 in serum. Intrathecal synthesis of specific antibodies was demonstrated with an index of 13.4 (norm < 2). Western blot confirmed the specificity of the reactions observed with the serum and CSF IgG. Culture of CSF produced significant growth of Borrelia within 7 days. Protein profile and reactions with poly- and monoclonal antibodies confirmed that the three strains belonged to B. burgdorferi.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Isolation of Borrelia burgdorferi in the cerebrospinal fluid of 3 children with neurological involvement]. 842 74

The neurologic symptoms of borreliosis can be classified to give distinct clinical pictures. The exact clinical characterisation allows an unambiguous and applicable classification of the different neurologic manifestations to be made. Due to high background seroprevalence of anti-Borrelia antibodies this classification is crucial for diagnosis. The most frequent neurologic manifestation is meningopolyradiculitis. It shows a typical pattern of symptoms, yet for differential diagnosis the crucial symptoms are the severe pains and the paresis of cranial nerves. In up to 10% of these patients no specific intrathecal antibody production was identified due to the time factor. Intrathecal antibody production cannot therefore be considered as the exclusive criterium for neuroborreliosis.
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PMID:Neurologic manifestation and classification of borreliosis. 900 96

The authors present an account on a complicated case of neuroborreliosis in a child. They draw attention to the possible development of paresis of the oculomotor muscles in borreliosis. They emphasize that this diagnosis should not be omitted in differential diagnostic considerations.
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PMID:[An unusual course of neuroborreliosis with ocular involvement in a child]. 907 12

Increased morbidity of viral tick borne encephalitis since the 90's indicates growing risk of Rother tick borne diseases, including neuroborreliosis. Analysis of demographical, epidemiological and clinical data of patients hospitalised in Departament on Infectious Diseases and Neuroinfections in years 2000-2005 revealed that among patients with Lyme disease 13% were with neuroborreliosis with broad spectrum of neurologic symptoms as cranial nerves paresis (mainly n.VII), as well concentration and memory disturbances, and general symptoms. Some of patiets did not recall tick bite and did not present earlier borreliosis symptoms. Imaging only supports recognitio.
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PMID:[Clinical forms of neuroborreliosis--the analysis of patients diagnosed in department of infectious diseases and neuroinfection medical academy in Bialystok between 2000-2005]. 1770 40

Tick-borne borreliosis (Borrelia burgdorferi) is a common and complex disorder affecting the skin, the joints and the nervous system. It progresses through different clinical stages. The clinical spectrum of neuroborreliosis has expanded since the introduction and widespread application of specific serological tests. We have investigated 41 patients with Bannwarth's meningopolyneuritis (MPN) as the classical form of neuroborreliosis, in a prospective (26 patients) and a retrospective (15 patients) study. When questioned, 19/41 patients reported a tick bite and only 15/41, erythema migrans as the characteristic early skin lesion. In 34/41 patients typical MPN characterized by painful radiculoneuritis and/or cranial neuritis, especially facial palsy, were seen. Among these, 3 had a complicated form with a progressive remitting relapsing course or focal central nervous system involvement (hemiparesis, cerebellar syndrome); 2 had mild meningitis and facial nerve palsy bilaterally without radicular pain; and in 5 radicular pain was the only symptom. MPN associated with Lyme arthritis was observed only once. In 2 patients in the retrospective study (no antibiotics in the acute stage) we saw a chronic spinal cord disorder with spastic paresis several years after uncomplicated MPN, accompanied in 1 of them by acrodermatitis chronica atrophicans (ACA), the typical late-onset borrelia-induced dermatosis. In the acute stage of the disease 40/41 patients had a cerebrospinal fluid (CSF) syndrome compatible with MPN (mononuclear pleocytosis, blood-brain barrier dysfunction, elevated IgG and/or oligoclonal bands). IgG antibody titers against borrelia antigen were elevated in all patients in the serum and in 21/30 also in the CSF. In all patients pain was an early and prominent symptom; the first symptoms are usually felt in the region of the tick bite or the erythema, initially as diffuse myalgia, arthralgia or pain in the connective tissue. In the further course the migrating pain becomes more radicular in character, without being limited to defined dermatomic areas or peripheral nerves. The intense, burning pain is characterized by exacerbation during the night. Peripherally and centrally acting analgesics have only minor effects. Often neurological deficits are still absent at this time. Erythema migrans with radicular pain in the region of the dermatological lesion was observed in 2 patients. This is an early manifestation of MPN. After MPN and/or Lyme arthritis a sympathetic reflex dystrophy (SRD) developed in 2 patients. In a further patient SRD was observed right at the beginning of the illness, immediately before MPN. There is a close clinical similarity between SRD and the acute stage of ACA. Therefore, borreliosis can be assumed to produce a painful skin dystrophy like SRD or ACA by direct injury to the sympathetic nerves even in the early clinical stage of the infection. The main conditions to be considered in the differential diagnosis are polymyalgia rheumatica; lumbar disk herniation; inflammatory radiculopathies of other origin (e.g. herpes zoster); painful neuropathies, including the diabetic thoraco-abdominal form; internal disorders of chest and abdomen with referred pain; lymphocytic meningitis of other origin, encephalomyelitis; and sympathetic reflex dystrophy. High-dose penicillin G i.v. is a potent analgesic in all patients with tick-borne neuroborreliosis.
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PMID:[Pain syndromes in tick-borne neuroborreliosis. Clinical aspects and differential diagnosis.]. 1841 56