"... To our knowledge this is the first reported case with an exclusive
psychiatric manifestation of Lyme disease...."

Biol Psychiatry 1999 Mar 15;45(6):795


Borrelia burgdorferi central nervous system infection presenting as an organic
schizophrenialike disorder.


Hess A, Buchmann J, Zettl UK, Henschel S, Schlaefke D, Grau G, Benecke R
Department of Neurology, University of Rostock, Germany.


BACKGROUND: We report on a 42-year-old female patient who presented with a
schizophreniform disorder and complete relief of symptoms after specific
therapy. METHODS: Cerebrospinal fluid and magnetic resonance imaging findings
led to the diagnosis of Lyme disease. RESULTS: To our knowledge this is the
first reported case with an exclusive psychiatric manifestation of Lyme
disease. CONCLUSIONS: In case of first manifestation of psychotic disorder,
although neurological symptoms are lacking, Lyme disease should be considered
and be excluded by cerebrospinal fluid analysis.


PMID: 10188012, UI: 99203827


Title: Untreated neuroborreliosis: Bannwarth's syndrome evolving into acute
schizophrenia-like psychosis. A case report.
Authors: Roelcke U, Barnett W, Wilder-Smith E, Sigmund D, Hacke W
Source: J Neurol 1992 Mar;239(3):129-31
Organization: Neurologische Klinik Universitat Heidelberg Federal Republic of
Germany.


Abstract:
In general, meningopolyradiculitis (Bannwarth's syndrome, stage 2 of
neuroborreliosis) follows a predictable monophasic self-limiting course. In
contrast, we report the case of a patient with an untreated
meningopolyradiculitis which evolved into acute schizophrenia-like psychosis
due to persistent infection with Borrelia burgdorferi. The psychosis resolved
within 1 week of treatment with ceftriaxone. This case shows that the usually
benign monophasic meningopolyradiculitis may progress to severe CNS
complications, which may have implications on current pathophysiological
beliefs.


Keywords:
Acute Disease, Antibodies, Bacterial, CF, Borrelia burgdorferi, IM, IP, Case
Report, Ceftriaxone, TU, Chronic Disease, Diagnosis, Differential,
Encephalitis, CF, CO, DT, MI, Human, IgG, CF, Lyme Disease, CF, CO, DT, PX,
Male, Meningitis, CF, CO, DT, MI, Middle Age, Organic Mental Disorders,
Psychotic, CF, DI, ET, Polyradiculitis, CO, DT, MI, Schizophrenia, DI,
Syndrome, Medline File


Language: German


Title: [Endogenous paranoid-hallucinatory syndrome caused by Borrelia
encephalitis]
Authors: Barnett W, Sigmund D, Roelcke U, Mundt C
Source: Nervenarzt 1991 Jul;62(7):445-7
Organization: Psychiatrische Universit:atsklinik, Heidelberg.


Abstract:
We describe a case with no neurological signs but marked psychiatric symptoms
induced by borrelia burgdorferi, whose clinical picture was indistinguishable
from an endogenous schizophrenia. The symptoms within one week under antibiotic
treatment with ceftriaxon, but afterwards the patient showed a mild organic
brain syndrome. The case demonstrated the aetiologic nonspecificity of paranoid
symptoms and hallucinations and emphasizes that in psychotic patients without
psychiatric history additional diagnostic measures should be performed.


Keywords:
Brain Damage, Chronic, DIAGNOSIS, PSYCHOLOGY, Case Report, Diagnosis,
Differential, Encephalitis, DIAGNOSIS, PSYCHOLOGY, English Abstract, Human,
Lyme Disease, DIAGNOSIS, PSYCHOLOGY, Male, Middle Age, Neuropsychological
Tests, Schizophrenia, Paranoid, DIAGNOSIS, PSYCHOLOGY, Syndrome


Language: Ger


Unique ID: 92018508


Title: Lyme disease: a neuropsychiatric illness.
Authors: Fallon BA, Nields JA
Source: Am J Psychiatry 1994 Nov;151(11):1571-83
Organization: Department of Psychiatry, College of Physicians and Surgeons,
Columbia University, New York.


Abstract:
OBJECTIVE: Lyme disease is a multisystemic illness that can affect the central
nervous system (CNS), causing neurologic and psychiatric symptoms. The goal of
this article is to familiarize psychiatrists with this spirochetal illness.
METHOD: Relevant books, articles, and abstracts from academic conferences were
perused, and additional articles were located through computerized searches and
reference sections from published articles. RESULTS: Up to 40% of patients with
Lyme disease develop neurologic involvement of either the peripheral or central
nervous system. Dissemination to the CNS can occur within the first few weeks
after skin infection. Like syphilis, Lyme disease may have a latency period of
months to years before symptoms of late infection emerge. Early signs include
meningitis, encephalitis, cranial neuritis, and radiculoneuropathies. Later,
encephalomyelitis and encephalopathy may occur. A broad range of psychiatric
reactions have been associated with Lyme disease including paranoia, dementia,
schizophrenia, bipolar disorder, panic attacks, major depression, anorexia
nervosa, and obsessive-compulsive disorder. Depressive states among patients
with late Lyme disease are fairly common, ranging across studies from 26% to
66%. The microbiology of Borrelia burgdorferi sheds light on why Lyme disease
can be relapsing and remitting and why it can be refractory to normal immune
surveillance and standard antibiotic regimens. CONCLUSIONS: Psychiatrists who
work in endemic areas need to include Lyme disease in the differential
diagnosis of any atypical psychiatric disorder. Further research is needed to
identify better laboratory tests and to determine the appropriate manner
(intravenous or oral) and length (weeks or months) of treatment among patients
with neuropsychiatric involvement.


Keywords:
Case Report, Comorbidity, Diagnosis, Differential, Female, Human, Lyme Disease,
DIAGNOSIS, EPIDEMIOLOGY, Male, Nervous System Diseases, DIAGNOSIS,
EPIDEMIOLOGY, Neuropsychological Tests, Organic Mental Disorders, DIAGNOSIS,
EPIDEMIOLOGY, Prevalence, Recurrence, Support, Non-U.S. Gov't, United States,
EPIDEMIOLOGY


Language: Eng


Unique ID: 95030026


Country: China,Nei Menggu
Abstract journal details: 2T09604Language: ChOther info: 8 ref.
Authors affiliation: Central Hospital of Forestry Industry, Greater Xing-An
Mountains, Nei Menggu, 022150, China.CABICODES: VV200


Abstract:
A serological survey to detect antibodies against Borrelia burgdorferi was
carried out in 134 cases of schizophrenia and 90 normal control subjects by IFA
in Nei Menggu, China. The results revealed that positive antibody detection was
38.9% in schizophrenics, much higher than in the control group, and
spirochaetes were isolated from a patient with schizophrenia. This indicated
that B. burgdorferi may be an aetiologic agent of schizophrenia (chronic
neurologic manifestations).Descriptors:
Lyme disease,antibodies,Borrelia burgdorferi,serological surveys,man,human
diseases,schizophrenia,nervous system diseasesAbstract no: 990500358