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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Delayed Diagnosis of Lyme Neuroborreliosis Presenting with Abducens Neuropathy Without Intrathecal Synthesis of Borrelia Antibodies

1
Department of Infectious, Chest Diseases, Dermatovenerology and Allergology, Vilnius University
2
UAB “Endemik diagnostika” Laboratory, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2013, 49(2), 16; https://doi.org/10.3390/medicina49020016
Received: 10 February 2011 / Accepted: 15 February 2013 / Published: 20 February 2013
Lyme borreliosis is the most common tick-born infection in Europe. Global climate change expanding the range of tick vectors and an increase in the incidence suggest that this disease will remain an important health issue in the forthcoming decades. Lyme borreliosis is a multisystem organ disorder affecting the nervous system in 10% to 15% of cases. Lyme neuroborreliosis can present with any disorder of the central and peripheral nervous systems. The neuro-ophthalmological manifestations are a rare feature of the disease. The intrathecal synthesis of Borrelia burgdorferi antibodies is of diagnostic importance, but in rare cases, immunoglobulins against the Borrelia burgdorferi antigen may not be detected. We report a case of possible Lyme neuroborreliosis presenting with sixth cranial nerve neuropathy at the onset of the disease further developing into typical meningoradiculitis and multiple mononeuropathy. Surprisingly, Borrelia burgdorferi antibodies were not detected in the cerebrospinal fluid.
Keywords: abducens neuropathy; chemokines; Lyme disease; Lyme neuroborreliosis; mononeuropathy multiplex; serological diagnosis abducens neuropathy; chemokines; Lyme disease; Lyme neuroborreliosis; mononeuropathy multiplex; serological diagnosis
MDPI and ACS Style

Radzišauskienė, D.; Ambrozaitis, A.; Marciuškienė, E. Delayed Diagnosis of Lyme Neuroborreliosis Presenting with Abducens Neuropathy Without Intrathecal Synthesis of Borrelia Antibodies. Medicina 2013, 49, 16.

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