Neurology Medical News about Lyme neuroborreliosis, prognosis

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Remaining complaints 1 year after treatment for acute Lyme neuroborreliosis; frequency, pattern and risk factors
European Journal of Neurology, 07/29/09

Ljostad U et al. – Remaining complaints, primarily subjective, are common after neuroborreliosis. Possible risk factors are: pre-treatment symptom duration ≥6 wks, high pre-treatment cerebrospinal fluid (CSF) cell count, and female gender. Presence of CSF oligoclonal bands (OCBs) may also predict a non-favorable outcome, pending further study.

Methods

Study of complaints 1 yr after treatment for neuroborreliosis, and to identify risk factors for non-favorable outcome
Follow-up of pts prospectively treated for neuroborreliosis
Assessment of outcome by composite clinical score
Univariate analyses and logistic regression. analysis by impact on outcome of clinical, demographic, and laboratory factors

Results

Of 85 pts 41 (48%) had remaining complaints; 14 had objective findings and 27 subjective symptoms
Remaining complaints associated with pre-treatment symptom duration ≥6 wks, high pre-treatment CSF cell count, and female gender
Presence of CSF OCBs not analyzed in logistic regression model due to many missing observations, but was more frequent both pre-treatment and after 12 mo among pts with remaining complaints vs complete recovery
Objective remaining findings, vs subjective symptoms, associated with pre-treatment symptom duration ≥6 wks
No difference in outcome between pts treated with IV ceftriaxone and vs oral doxycycline

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