[Neuroborreliosis: diagnostic difficulties]

Abstract

Borreliosis is a condition caused by spirochaete-Borrelia burgdorferi, characterised by multiorgan changes and prolonged course with three consecutive stages. The number of diagnosed cases in Poland tends to increase. This is due to the availability of diagnosis tests. Owing to the analysis of blood and CSF by the fluorimetric method 3M IgG/IgM Fastlyme, neuroborreliosis was confirmed in 5 patients (hospitalised in Neurological Clinic of Medical Academy in Białystok). Three of the cases were characterised by a bilateral palsy of facial nerve and abnormal CSF, as evidenced by pleocytosis (100% lymphocytes) and elevated protein. Patient 4 diagnosed by dermatologists as having Acrodermatitis atrophicans, should be classified, however, as the third stage of the disease, while according to neurological changes--namely a lesion of shoulder plexus--as the second stage. Evaluation of patient 5 presented most difficulties. Considering long-term disease and the time from the onset to the admission to the neurological clinic, she was likely to develop the third stage of the disease, and therefore, our treatment failed to be so effective as in aforementioned cases.