[Neuroborreliosis in a patient with progressive supranuclear paralysis. An association or the cause?].
BACKGROUND
Many different neurological conditions may be seen in the later stages of Lyme's Disease, such as blindness, epileptic crises, CVA, extrapyramidal disorders, amyotrophic lateral sclerosis, and dementia may be yet another form of presentation of chronic infection due to Borrelia burgdorferi (Bb). Progressive Supranuclear Paralysis (PSP), a disorder of unknown aetiology, considered to be the commonest cause of Parkinsonism-plus, one of the symptoms of which is dementia, has never been mentioned in this type of differential diagnosis.


METHODS
We present the case of a 78 year old man with sub-acute mental deterioration, Bb positive serology in both plasma and CSF, and with clinical and epidemiological features compatible with Lyme's Disease. Complementary tests were negative. The syndrome corresponded to Lyme's Disease and improved after treatment with ceftriaxona.


CONCLUSIONS
We consider aspects of the aetiology of PSP which are still not clear. In our patient, the aetiology seemed to be Bb infection, according to the criteria of the original description of the disease and in view of the neuropathological findings which have shown Bb in the substancia nigra of the mid-brain and the existence of an animal model in which Bb shows a particular tendency to colonize infratentorial structures.
García-Moreno
J M
JM
Departamento de Inmunología, Hospital Universitario Virgen de la Macarena, Sevilla, España. Ayuso@arrakis.es
Izquierdo
G
G
Chacón
J
J
Angulo
S
S
Borobio
M V
MV
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification*; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D003704:Dementia / Q000209:etiology; D004569:Electroencephalography; D019066:Facies; D005625:Frontal Lobe / Q000000981:diagnostic imaging; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D010296:Parietal Lobe / Q000000981:diagnostic imaging; D013378:Substantia Nigra / Q000382:microbiology* / Q000473:pathology*; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon
D000978:Antiparkinson Agents; D002511:Cephalosporins; D002443:Ceftriaxone
Neuroborreliosis en un paciente con parálisis supranuclear progresiva: asociación o causa?