Sciatica, disk herniation, and neuroborreliosis. A report of four cases.
We report four cases of sciatica in patients with same-level disk herniation confirmed by computed tomography and a final diagnosis of acute radiculitis caused by Borrelia burgdorferi, with a favorable response to ceftriaxone therapy. The neurological manifestations of Lyme disease are protean, and a potential contribution of concomitant disk disease to sciatica can lead to diagnostic wanderings. Disk lesions and infectious conditions that can cause sciatica are discussed. Whether a favorable response to antibiotic therapy should be taken as proof of B. burgdorferi radiculitis deserves discussion. In practice, in a patient with clinical manifestations suggesting disk-related nerve root pain and residing or having traveled to an endemic area, B. burgdorferi infection should be looked for, as both etiologies can coexist.
Dupeyron
Arnaud
A
Physical Medicine and Rehabilitation Unit, Strasbourg Teaching Hospitals, Avenue Molière, 67098 Strasbourg cedex, France. arnaud.dupeyron@chru-strasbourg.fr
Lecocq
Jehan
J
Jaulhac
Benoît
B
Isner-Horobeti
Marie-Eve
ME
Vautravers
Philippe
P
Cohen-Solal
Julien
J
Sordet
Christelle
C
Kuntz
Jean-Louis
JL
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications*; D008159:Lumbar Vertebrae; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000382:microbiology*; D012447:Sacrum; D012585:Sciatica / Q000150:complications*
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone