title: 5-hydroxytryptamine and Lyme disease. Opportunity for a novel therapy to reduce the cerebellar tremor?
abstract: Lyme boreliosis is caused by the spirochete Borrelia burdorferi, which is transmitted by ticks. A 59 year-old woman developed pyrexia, strong headaches, ataxia, dysarthria and tremor of the limbs after a tick bite. She was unable to work and eat on her own. She was hospitalized three times and diagnosed with cerebellar intention tremor, cerebellar ataxia, dysarthria, bilateral horizontal gaze paralysis and a central lesion of the left facial nerve. There were no pyramidal, sensory or psychiatric disturbances. The brain MRI showed multifocal leucoencephalopathy with many hyperintense areas in both hemispheres, as well as in the left superior pedunculus cerebellaris. Diagnosis was confirmed by serologic examination. Treatment with cephtriaxone, doxycycline, methylprednisolone, cephixime and ciprofloxacine was administered without effect on the tremor, ataxia and horizontal gaze paralysis. Treatment was then administered with 5-hydroxytriptamine (5-HT) in increased doses. The result of the three-month treatment with 5-HT was a gradual diminution of the tremor and the ataxia and an increase in the ability to eat, walk and work independently.
authors.affiliation: Department Medicinal Information and Non-interventional studies, Bulgarian Drug Agency, Sofia, Bulgaria.
authors.forename: G K
authors.initials: GK
authors.lastname: Maximov
authors.affiliation: Neuromed Center for Neurology and Neurosurgery, Military Medical Academy, Sofia, Bulgaria.
authors.forename: K G
authors.initials: KG
authors.lastname: Maximov
authors.affiliation: Onkoderma- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria; Department of Dermatology and Venereology, Medical University of Plovdiv, Medical Faculty, Plovdiv, Bulgaria.
authors.forename: A A
authors.initials: AA
authors.lastname: Chokoeva
authors.affiliation: Department of Dermatology, University of Rome G. Marconi Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Lotti
authors.affiliation: Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.affiliation: University of Virginia Health System, Department of Pathology, Charlottesville, VA USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Patterson
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Dermatology, University Hospital of Messina, Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Guarneri
authors.affiliation: Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Reggio Emilia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tana
authors.affiliation: History Department, G.Marconi University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fioranelli
authors.affiliation: University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India.
authors.forename: M G
authors.initials: MG
authors.lastname: Roccia
authors.affiliation: Department of Dermatology, Wakayama Medical University, Wakayama, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kanazawa
authors.affiliation: Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.
authors.forename: G
authors.initials: G
authors.lastname: Tchernev
mesh_terms: D002524:Cerebellar Ataxia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012701:Serotonin / Q000627:therapeutic use*; D014202:Tremor / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D012701:Serotonin