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.
Physical Medicine and Rehabilitation Unit, Strasbourg Teaching Hospitals, Avenue Molière, 67098 Strasbourg cedex, France. arnaud.dupeyron@chru-strasbourg.fr
Arnaud
A
Dupeyron
Jehan
J
Lecocq
Benoît
B
Jaulhac
Marie-Eve
ME
Isner-Horobeti
Philippe
P
Vautravers
Julien
J
Cohen-Solal
Christelle
C
Sordet
Jean-Louis
JL
Kuntz
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