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Lyme Borreliosis causing severe encephalopathy and nocturnal abdominal pain in a patient with a ventriculo-peritoneal shunt

par Manto, Mario ;Nubourgh, Yves;Guillaume, Bénédicte;Jacquy, Jean
Référence European journal of neurology, 3, 2, page (160-163)
Publication Publié, 1996-03

Article révisé par les pairs

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Résumé :

We report the case of a 76-year-old patient with a previous history of normal-pressure hydrocephalus treated with a ventriculo-peritoneal shunting device. He was admitted one year after for severe encephalopathy and nocturnal abdominal pain. Computerized tomography (CT) of the brain showed normal ventricular size. A mild increase of protein level was present in cerebrospinal fluid (CSF). Rising levels of IgG antibodies against Borrelia burgdorferi (Bb) were detected in blood but not in CSF. Anti-Bb IgM antibodies were not detected neither in blood nor in CSF. Abdominal investigations were all normal. Intravenous treatment with ceftriaxone was followed by a dramatic improvement. We suggest making serial determinations of antibodies against Bb in patients presenting encephalopathy associated with nocturnal abdominal pain to exclude a Lyme disease. This could also avoid needless investigations and inappropriate revision of an eventual ventriculoperitoneal shunting device.