Optic nerve involvement in patients with Lyme neuroborreliosis: an electrophysiological study

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Documenta Ophthalmologica Pub Date : 2024-04-15 DOI:10.1007/s10633-024-09975-w

Jana Szanyi, Jan Kremlacek, Zuzana Kubova, Miroslav Kuba, Frantisek Vit, Jana Langrova, Pavel Gebousky, Juraj Szanyi

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Abstract

Purpose

The aim of this neurophysiological study was to retrospectively analyze visual evoked potentials (VEPs) acquired during an examination for diagnosing optic nerve involvement in patients with Lyme neuroborreliosis (LNB). Attention was focused on LNB patients with peripheral facial palsy (PFP) and optic nerve involvement.

Methods

A total of 241 Czech patients were classified as having probable/definite LNB (193/48); of these, 57 were younger than 40 years, with a median age of 26.3 years, and 184 were older than 40 years, with a median age of 58.8 years. All patients underwent pattern-reversal (PVEP) and motion-onset (MVEP) VEP examinations.

Results

Abnormal VEP results were observed in 150/241 patients and were noted more often in patients over 40 years (p = 0.008). Muscle/joint problems and paresthesia were observed to be significantly more common in patients older than 40 years (p = 0.002, p = 0.030), in contrast to headache and decreased visual acuity, which were seen more often in patients younger than 40 years (p = 0.001, p = 0.033). Peripheral facial palsy was diagnosed in 26/241 LNB patients. Among patients with PFP, VEP peak times above the laboratory limit was observed in 22 (84.6%) individuals. Monitoring of patients with PFP and pathological VEP showed that the adjustment of visual system function occurred in half of the patients in one to more years, in contrast to faster recovery from peripheral facial palsy within months in most patients.

Conclusion

In LNB patients, VEP helps to increase sensitivity of an early diagnostic process.

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莱姆神经源性疾病患者的视神经受累：一项电生理学研究

目的本项神经生理学研究旨在回顾性分析莱姆神经母细胞瘤（LNB）患者在诊断视神经受累的检查中获得的视觉诱发电位（VEP）。方法共有 241 名捷克患者被归类为可能/不确定 LNB 患者（193/48），其中 57 人年龄小于 40 岁，中位年龄为 26.3 岁，184 人年龄大于 40 岁，中位年龄为 58.8 岁。所有患者均接受了模式反转（PVEP）和运动起始（MVEP）VEP 检查。结果150/241 例患者的 VEP 结果均出现异常，40 岁以上的患者更常见（P = 0.008）。据观察，肌肉/关节问题和麻痹在 40 岁以上的患者中更为常见（p = 0.002，p = 0.030），而头痛和视力下降则多见于 40 岁以下的患者（p = 0.001，p = 0.033）。26/241 名 LNB 患者被诊断为周围性面瘫。在 PFP 患者中，有 22 人（84.6%）的 VEP 峰值时间超过了实验室极限。对 PFP 和病理 VEP 患者的监测显示，半数患者的视觉系统功能在一至数年内得到调整，而大多数患者的周围性面瘫在数月内恢复较快。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Documenta Ophthalmologica 医学-眼科学

CiteScore

3.50

自引率

21.40%

发文量

审稿时长

>12 weeks

期刊介绍： Documenta Ophthalmologica is an official publication of the International Society for Clinical Electrophysiology of Vision. The purpose of the journal is to promote the understanding and application of clinical electrophysiology of vision. Documenta Ophthalmologica will publish reviews, research articles, technical notes, brief reports and case studies which inform the readers about basic and clinical sciences related to visual electrodiagnosis and means to improve diagnosis and clinical management of patients using visual electrophysiology. Studies may involve animals or humans. In either case appropriate care must be taken to follow the Declaration of Helsinki for human subject or appropriate humane standards of animal care (e.g., the ARVO standards on Animal Care and Use).