La neuroborreliosis de Lyme tardía — también denominada neuroborreliosis de Lyme crónica — se caracteriza por síntomas neurológicos que se desarrollan de forma gradual a lo largo de meses a años, y representa una presentación diferenciada y más avanzada de la enfermedad.
Los objetivos principales son la resolución de los síntomas neurológicos clínicos y la regresión de la pleocitosis en el LCR. Los pacientes con síntomas incapacitantes que persistan tras el tratamiento pueden requerir una evaluación de seguimiento del LCR.
DOI: 10.3205/000349
Late Lyme neuroborreliosis (also known as chronic Lyme neuroborreliosis): Symptoms last for months to years.
The neurological symptoms develop gradually over months (to years).
Typical manifestations: encephalomyelitis with spastic-ataxic gait disorder and bladder disorder, encephalitic symptoms with change in personality, confusion, cognitive impairment, impaired consciousness and epileptic seizures.
Late Lyme neuroborreliosis should be treated with one of the following antibiotics: doxycycline, ceftriaxone, cefotaxime, penicillin G.
Antibiotic treatment for late Lyme neuroborreliosis should be carried out over a period of 14–21 days.
Treatment success should be assessed on the basis of the clinical symptoms.
If a patient continues to have impairing symptoms 6 months after treatment, CSF testing should be repeated; if there are doubts that the symptoms are improving, an earlier CSF follow-up analysis can be considered; if pleocytosis persists, a new course of antibiotic treatment should be carried out after other diagnoses have been ruled out.
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