Abstract
Borrelia burgdorferi (Bb) can cause a large number of neurological symptoms. Although extrapyramidal disturbances are rare (representing less than 2% of all neurological complications), diffuse choreic dyskinesias have been described during the course of mild encephalitis. The data published in the literature suggest that there are clinical and neurological analogies between neuroborreliosis and multiple sclerosis (MS). The presence of specific anti-Bb antibodies in cerebrospinal fluid is a discriminating factor that allows a diagnosis of neuroborreliosis to be made. We describe the case of a patient with Lyme disease, characterised by widespread chorea and behavioural disturbances. Emphasis is placed on the atypical onset and evolution, the difficulties encountered in formulating a diagnosis, and the uncertainties concerning the pathophysiology and clinical/neuroradiological correlations of the disease.
Sommario
La “Borrelia burgdorferi” (Bb) può causare numerosi sintomi neurologici. Benché i disturbi extrapiramidali siano rari, meno del 2% di tutte le complicanze neurologiche, sono descritte discinesie coreiche diffuse in corso di lievi encefaliti. I dati della letteratura suggeriscono analogie cliniche e neuroradiologiche tra neuroborreliosi e sclerosi multipla (SM); il riscontro di anticorpi specifici per la Bb nel liquor discrimina le due entità patologiche e consente la diagnosi di neuroborreliosi. Descriviamo un caso di malattia di Lyme, caratterizzato da corea diffusa e disturbi comportamentali. Si sottolineano l’esordio e l’evoluzione atipici, la difficoltà dell’iter diagnostico, le incertezze sulla fisiopatologia e sulle correlazioni clinico-neuroradiologiche.
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Piccolo, I., Sterzi, R., Defanti, C.A. et al. Chorea as a symptom of neuroborreliosis: a case study. Ital J Neuro Sci 19, 235–239 (1998). https://doi.org/10.1007/BF02427611
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DOI: https://doi.org/10.1007/BF02427611