Wien Med Wochenschr. 2009 Jan;159(1-2):58-61.
Normal pressure hydrocephalus or neuroborreliosis?
Aboul-Enein F, Kristoferitsch W. Department of Neurology, Sozialmedizinisches Zentrum Ost, Donauspital, Vienna,Austria, firstname.lastname@example.org.
BACKGROUND: An 80-year-old woman presented with progressive cognitive declineand with a 6-month history of gait ataxia. Brain MRI depicted enlargedventricles and periventricular lesions. Clinical improvement after CSF spinaltap test suggested a normal pressure hydrocephalus syndrome. But CSF pleocytosiswith activated lymphocytes and plasma cells and intrathecal Borrelia burgdorferispecific antibody production led to the diagnosis of active Lymeneuroborreliosis. Clinical symptoms of NPH resolved after a course ofceftriaxone.
METHODS: Neurological examination, MMSE, brain MRI, lumbarpuncture, spinal tap test.
RESULTS: Dementia due Borrelia burgdorferi infectionwith chronic meningitis was reversible after treatment with iv.2 g ceftriaxoneper day for 4 weeks.
CONCLUSIONS: Rare but treatable dementias must be diagnosedpromptly to slow down or even reverse cognitive decline. PMID: 19225737 [PubMed - as supplied by publisher]