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Clin Infect Dis. 2019 Oct 9. pii: ciz997. doi: 10.1093/cid/ciz997. [Epub ahead of print]

Risk of neurological disorders in patients with European Lyme neuroborreliosis. A nationwide population-based cohort study.

Author information

1
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
2
Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.
3
Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Denmark.
4
Department of Natural Sciences and Environment, Roskilde University, Denmark.
5
Departments of Clinical Microbiology, Aalborg University hospital, Aalborg, Denmark.
6
Departments of Infectious Diseases, Aalborg University hospital, Aalborg, Denmark.
7
Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, Odense, Denmark.
8
Department of Clinical Microbiology, Vejle Hospital, Vejle, Denmark.
9
Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
10
Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark.
11
Department of Clinical Microbiology, Herlev University Hospital, Copenhagen, Denmark.
12
Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
13
Department of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark.
14
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
15
Department of Clinical Microbiology, Hvidovre University Hospital, Copenhagen, Denmark.

Abstract

BACKGROUND:

Lyme neuroborreliosis (LNB) caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex has been suggested to be associated with a range of neurological disorders. In a nationwide population-based cohort-study we examined the association between LNB and dementia, Alzheimer's disease, Parkinson's disease, motor neuron disease, epilepsy and Guillain-Barré syndrome.

METHODS:

We used national registers to identify all Danish residents diagnosed during 1986-2016 with LNB (n=2,067) and a gender and age matched comparison cohort from the general population (n=20,670), and calculated risk estimates and hazard ratios (HR).

RESULTS:

We observed no long-term increased risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases or epilepsy. However, within the first year eight (0.4%) of the LNB patients developed epilepsy compared with 20 (0.1%) of the comparison cohort (difference 0.3%, 95% CI: 0.02% to 0.6%). In the LNB group 11 (0.5%) patients were diagnosed with Guillain-Barré syndrome within the first year after LNB diagnosis compared with 0 (0.0%) in the comparison cohort. After the first year, the risk of Guillain-Barré was not increased.

CONCLUSION:

LNB patients did not have increased long-term risk of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy or Guillain-Barré. Although absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.

KEYWORDS:

Borrelia burgdorferi; European Lyme Neuroborreliosis; Long-Term-Risk; Nation-wide population-based cohort study; Neurodegenerative Disorders

PMID:
31598647
DOI:
10.1093/cid/ciz997

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