Case 11-2007: A 59-year-old man with neck pain, weakness in the arms, and cranial-nerve palsies

New England Journal of Medicine

Volumn 356, Issue 15, 2007, Pages 1561-1570

  Greer, David M ^a,b   Schaefer, Pamela W ^a,b   Plotkin, Scott R ^a,b   Hasserjian, Robert P ^a,b   Steere, Allen C ^a,b  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CEFTRIAXONE; GADOLINIUM; NALOXONE; PROPOFOL; SALBUTAMOL; BACTERIUM ANTIBODY;

ADULT; ARM WEAKNESS; ARTICLE; AUTOIMMUNE DISEASE; BORRELIA INFECTION; BRAIN INFECTION; BRUCELLOSIS; CASE REPORT; CEREBROSPINAL FLUID ANALYSIS; CLINICAL FEATURE; CRANIAL NERVE PARALYSIS; DIFFERENTIAL DIAGNOSIS; GUILLAIN BARRE SYNDROME; HUMAN; INFLAMMATION; LUMBAR PUNCTURE; MALE; MENINGEAL METASTASIS; MYASTHENIA GRAVIS; NECK PAIN; NEUROSYPHILIS; PRIORITY JOURNAL; WEGENER GRANULOMATOSIS; B LYMPHOCYTE; BLOOD; BORRELIA BURGDORFERI; CENTRAL NERVOUS SYSTEM; CEREBROSPINAL FLUID; CHEMISTRY; CLINICAL OBSERVATION; CLINICAL STUDY; CRANIAL NEUROPATHY; CYTOLOGY; DIAGNOSIS; IMMUNOLOGY; ISOLATION AND PURIFICATION; LUMBAR VERTEBRA; LYME DISEASE; MIDDLE AGED; MUSCLE WEAKNESS; NUCLEAR MAGNETIC RESONANCE IMAGING; PAIN; PARALYSIS; PATHOLOGY; THROMBOCYTOPENIA;

ANTIBODIES, BACTERIAL; B-LYMPHOCYTES; BORRELIA BURGDORFERI; CENTRAL NERVOUS SYSTEM; CEREBROSPINAL FLUID; CRANIAL NERVE DISEASES; DIAGNOSIS, DIFFERENTIAL; HUMANS; LUMBAR VERTEBRAE; LYME NEUROBORRELIOSIS; MAGNETIC RESONANCE IMAGING; MALE; MIDDLE AGED; MUSCLE WEAKNESS; PAIN; PARALYSIS; THROMBOCYTOPENIA;

EID: 34247130420     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMcpc079005     Document Type: Article

References (35)

1. Newman NJ, Slamovits TL, Friedland S, Wilson WB. Neuro-ophthalmic manifestations of meningocerebral inflammation from the limited form of Wegener's granulomatosis. Am J Ophthalmol 1995;120:613-21.
2. Colover J. Sarcoidosis with involvement of the nervous system. Brain 1948;71:451-75.
3. Luxon L, Lees AJ, Greenwood RJ. Neurosyphilis today. Lancet 1979;1:90-3.
4. Reik L, Steere AC, Bartenhagen NH, Shope RE, Malawista SE. Neurologic abnormalities of Lyme disease. Medicine (Baltimore) 1979;58:281-94.
5. Abbott RA, Hammans S, Margarson M, Aji BM. Diaphragmatic paralysis and respiratory failure as a complication of Lyme disease. J Neurol Neurosurg Psychiatry 2005;76:1306-7.
6. Leptomeningeal metastases. In: Posner JB. Neurologic complications of cancer. Philadelphia: F.A. Davis, 1995:143-71.
7. CBTRUS. Statistical report: primary brain tumors in the United States, 1998-2002. Hinsdale, IL: Central Brain Tumor Registry of the United States, 2005. (Accessed March 19, 2007, at http://www.cbtrus.org/reports//2005-2006/ 2006report. pdf.)
8. Lachance DH, O'Neill BP, Macdonald DR, et al. Primary leptomeningeal lymphoma: report of 9 cases, diagnosis with immunocytochemical analysis, and review of the literature. Neurology 1991;41:95-100.
9. Bollen EL, Brouwer RE, Hamers S, et al. Central nervous system relapse in non-Hodgkin lymphoma: a single-center study of 532 patients. Arch Neurol 1997;54:854-9.
10. Glass JP, Melamed M, Chernik NL, Posner JB. Malignant cells in cerebrospinal fluid (CSF): the meaning of a positive CSF cytology. Neurology 1979;29:1369-75.
11. Shenkier TN. Unusual variants of primary central nervous system lymphoma. Hematol Oncol Clin North Am 2005;19:651-64.
12. Roma AA, Garcia A, Avagnina A, Rescia C, Elsner B. Lymphoid and myeloid neoplasms involving cerebrospinal fluid: comparison of morphologic examination and immunophenotyping by flow cytometry. Diagn Cytopathol 2002;27:271-5.
13. van der Velden VH, Hochhaus A, Cazzaniga G, Szczepanski T, Gabert J, van Dongen JJ. Detection of minimal residual disease in hematologic malignancies by real-time quantitative PCR: principles, approaches, and laboratory aspects. Leukemia 2003;17:1013-34.
14. Jacobsen M, Zhou D, Cepok S, et al. Clonal accumulation of activated CD8+ T cells in the central nervous system during the early phase of neuroborreliosis. J Infect Dis 2003;187:963-73.
15. Owens GP, Ritchie AM, Burgoon MP, Williamson RA, Corboy JR, Gilden DH. Single-cell repertoire analysis demonstrates that clonal expansion is a prominent feature of the B cell response in multiple sclerosis cerebrospinal fluid. J Immunol 2003;171:2725-33.
16. Lakos A. CSF findings in Lyme meningitis. J Infect 1992;25:155-61.
17. Walther EU, Seelos K, Bise K, Mayer M, Straube A. Lyme neuroborreliosis mimicking primary CNS lymphoma. Eur Neurol 2004;51:43-5.
18. Kieslich M, Fiedler A, Driever PH, Weis R, Schwabe D, Jacobi G. Lyme borreliosis mimicking central nervous system malignancy: the diagnostic pitfall of cerebrospinal fluid cytology. Brain Dev 2000;22:403-6.
19. Steere AC, Coburn J, Glickstein L. The emergence of Lyme disease. J Clin Invest 2004;113:1093-101.
20. Smith RP, Schoen RT, Rahn DW, et al. Clinical characteristics and treatment outcome of early Lyme disease in patients with microbiologically confirmed erythema migrans. Ann Intern Med 2002;136:421-8.
21. Steere AC, Sikand VK. The presenting manifestations of Lyme disease and the outcomes of treatment. N Engl J Med 2003;348:2472-4.
22. Steere AC, Dhar A, Hernandez J, et al. Systemic symptoms without erythema migrans as the presenting picture of early Lyme disease. Am J Med 2003;114:58-62.
23. Krause PJ, Telford SR III, Spielman A, et al. Concurrent Lyme disease and babesiosis: evidence for increased severity and duration of illness. JAMA 1996;275:1657-60.
24. Krause PJ, McKay K, Thompson CA, et al. Disease-specific diagnosis of coinfecting tickborne zoonoses: babesiosis, human granulocytic ehrlichiosis, and Lyme disease. Clin Infect Dis 2002;34:1184-91.
25. Ishaq S, Quinet R, Saba J. Phrenic nerve paralysis secondary to Lyme neuroborreliosis. Neurology 2002;59:1810-1.
26. Kirsch M, Ruben FL, Steere AC, Duray PH, Norden CW, Winkelstein A. Fatal adult respiratory distress syndrome in patient with Lyme disease. JAMA 1988;259:2737-9.
27. Reik L Jr. Stroke due to Lyme disease. Neurology 1993;43:2705-7.
28. Recommendations for test performance and interpretation from the Second International Conference on Serologic Diagnosis of Lyme Disease. MMWR Morb Mortal Wkly Rep 1995;44:590-1.
29. Dressler F, Whalen JA, Reinhardt BN, Steere AC. Western blotting in the serodiagnosis of Lyme disease. J Infect Dis 1993;167:392-400.
30. Steere AC, Berardi VP, Weeks KE, Logigian EL, Ackermann R. Evaluation of the intrathecal antibody response to Borrelia burgdorferi as a diagnostic test for Lyme neuroborreliosis. J Infect Dis 1990;161:1203-9.
31. Wilske B, Schierz G, Preac-Mursic V, et al. Intrathecal production of specific antibodies against Borrelia burgdorferi in patients with lymphocytic meningoradiculitis (Bannwarth's syndrome). J Infect Dis 1986;153:304-14.
32. Case Records of the Massachusetts General Hospital (Case 29-1984). N Engl Med 1984;311:172-81.
33. Baig S, Olsson T, Link H. Predominance of Borrelia burgdorferi specific B cells in cerebrospinal fluid in neuroborreliosis. Lancet 1989;2:71-4.
34. Rupprecht TA, Pfister HW, Angele B, Kastenbauer S, Wilske B, Koedel U. The chemokine CXCL13 (BLC): a putative diagnostic marker for neuroborreliosis. Neurology 2005;65:448-50.
35. Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006;43:1089-134.