Summary
Seventy-five patients with neurological symptoms of Lyme borreliosis were randomly assigned to intravenous treatment with either penicillin G or doxycycline. After 12 months the treatments were equally effective regarding the clinical picture and laboratory findings. No patient was considered to be a treatment failure. However, one-third of the patients showed delayed recovery, particularly after a longer primary disease duration. A slow recovery, lasting years, was typical of subacute or chronic borreliosis.
Similar content being viewed by others
References
Ackermann R, Gollmer E, Rehse-Küpper B (1985) Progressive Borrelien-Enzephalomyelitis. Dtsch Med Wochenschr 110:92–97
Benach IL, Bosler EM, Hanrahan IP (1983) Spirochetes isolated from the blood of two patients with Lyme Disease. N Engl J Med 308:740–742
Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwaldt E, Davis JP (1982) Lyme disease — a tick-borne spirochetosis? Science 216:1317–1319
Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwaldt E, Davis JP (1983) Erythema chronicum migrans — a tick-borne spirochetosis? Acta Trop 40:79–83
Craft JE, Grodzicki R, Steere AC (1984) Antibody response in Lyme disease: Evaluation of diagnostic tests. J Infect Dis 149:789–795
Dattwyler RJ, Halperin JJ (1987) Failure of tetracycline therapy in early Lyme disease. Arthritis Rheum 30:448–450
Dattwyler RJ, Halperin JJ, Pass H (1987) Ceftriaxone as effective therapy in refractory Lyme Disease. J Infect Dis 155:1322–1325
Hanny PE, Haenselmann HJ (1983) Die Lyme Krankheit aus der Sicht des Neurologen. Schweiz Med Wochenschr 117:901–915
Hollstroem E (1951) Penicillin treatment of Erythema chronicum migrans Afzelius. Acta Dermatol Venerol (Stockh) 38:285–289
Johnson RC, Klein GC, Schmid GB (1985) Susceptibility of the Lyme Disease spirochete to seven antimicrobial agents. Yale J Biol Med 57:549–553
Johnson RC, Kodner C, Russell M (1987) In vitro and in vivo susceptibility of the lyme disease spirochete, Borrelia burgdorferi, to four antimicrobial agents. Antimicrob Agents Chemother 31:164–167
Johnston YE, Duray PH, Steere AC, Kashgarian M, Buza J, Malawista SE, Askenase PW (1985) Lyme arthritis. Spirochetes found in synovial microangiopathic lesions. Am J Pathol 118:26–34
Kohlhepp W, Mertens HG (1985) Chronische Meningomyeloradikulitis durch Ixodes-ricinus-Spirochäten — eine der Metalues analoge Spirochätose? Verhandl Dtsch Neurol Ges, vol 3. Springer, Berlin Heidelberg New York, pp 747–749
Kohlhepp W, Mertens HG, Oschmann P (1986) Acute and chronic illness after tick-bite Borrelia burgdorferi infections Zentralbl Bakteriol Hyg [A] 263:365–371
Kohlhepp W, Mertens HG, Oschmann P, Rohrbach E (1987) Akute und chronische Erkrankungen bei zeckenvermittelter Borreliose. Nervenarzt 58:557–563
Kohlhepp W, Kuhn W, Krüger H (1989) Extrapyramidal features in central Lyme borreliosis. Eur Neurol 29:150–155
Kristoferitsch W, Baumhackl U, Sluga E, Stanek G, Zeiler K (1986) High-dose penicillin therapy in meningopolyneuritis Garin-Bujadoux-Bannwarth. Clinical and cerebrospinal fluid data. Zentralbl Bakteriol Hyg [A] 263:357–364
Martin R, Martens U, Sticht-Groh V (1988) Persistent intrathecal secretion of oligoclonal, Borrelia burgdorferi-specific IgG in chronic meningoradiculitis. J Neurol 235:229–233
Martin R, Ortlauf J, Sticht-Groh V (1988) Borrelia burgdorferi specific autoreactive T-cell lines from cerebrospinal fluid in Lyme radiculomyelitis. Ann Neurol 24:509–516
Mursic VP, Wilske B, Schierz G (1987) In vitro and in vivo susceptibility of Borrelia burgdorferi. Eur J Clin Microbiol 6:424–426
Pfister HW, Einhäupl K, Preac-Mursic V, Wilske B, Schierz G (1984) The spirochetal etiology of lymphocytic meningoradiculitis of Bannwarth. J Neurol 231:141–144
Reik L, Steere AC, Bartenhagen NH, Shope RE, Malawista E (1979) Neurologic abnormalities of Lyme disease. Medicine (Baltimore) 58:281–294
Reik L, Smith L, Khan A, Nelson W (1985) Demyelinating encephalopathy in Lyme disease. Neurology 35:267–269
Schaltenbrand G (1962) Radikulomyelomeningitis nach Zeckenbiss. Münch Med Wochenschr 18:829
Steere AC, Malawista SE, Newmann J, Spieler PN, Bartenhagen NH (1980) Antibiotic therapy in Lyme disease. Ann Intern Med 93:1–8
Steere AC, Pachner A, Malawista SE (1983) Neurologic abnormalities of lyme disease: successful treatment with high-dose intravenous penicillin. Ann Intern Med 99:767–772
Steere AC, Green J, Hutschinson GJ, Rahn DW, Pachner A, Schoen RT, Sigal L, Taylor E, Malawista SE (1986) Treatment of Lyme disease. Zentralbl Bakteriol Hyg [A] 263:352–356
Weder B, Wiedersheim P, Matter LO, Steck A, Otto F (1987) Chronic progressive neurological involvement in Borrelia burgdorferi infection. J Neurol 234:40–43
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kohlhepp, W., Oschmann, P. & Mertens, HG. Treatment of Lyme borreliosis. J Neurol 236, 464–469 (1989). https://doi.org/10.1007/BF00328508
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00328508