Lymphocytic meningoradiculitis


Lymphocytic meningoradiculitis

Description, Causes and Risk Factors:

Lymphocytic meningoradiculitis is a radicular neuralgia associated with a chronic lymphocytic pleocytosis in cerebrospinal fluid and frequently with unilateral or bilateral peripheral facial weakness. Most reported cases have occurred during the summer among adults living in central Europe. Lymphocytic meningoradiculitis has occurred in the United States in a few patients with Lyme disease and erythema chronicum migrans. However, it may occur independently.

The most frequent cause of lymphocytic meningoradiculitis is the entry of a microorganism-such as a bacterium or a virus from an infection elsewhere in the body. The microorganisms travel through the blood and into the meninges and cerebral spinal fluid.

lymphocytic meningoradiculitis

In the bloodstream, infection-causing microorganisms are fought off by white blood cells, an important part of the immune system. However, there are no white blood cells in the cerebral spinal fluid to fight infectious agents.

Once infectious organisms have entered the cerebrospinal fluid, the body's defenses cannot control their rapid growth and the disease races through the delicate surfaces and fluids of the central nervous system.

As the immune system gears up to fight off the microorganisms, it sends out chemical signals that produce inflammation and interfere with the normal functioning of the central nervous system. That, in turn, causes swelling and increased pressure inside the skull, and disrupts the brain's normal functioning.

Reserch: In 1987, follow-up studies were conducted on 72 patients who had had meningoradiculitis and encephalomyelitis (8 patients) due to Borrelia burgdorferi 5-27 years previously. These patients had not been treated with antibiotics, either during the acute disease or during the interval prior to follow-up studies. The patients had exhibited the typical symptoms of Bannwarth's syndrome during the acute phase. At the follow-up studies, 33 patients showed no, and 23 only mild, clinical residual symptoms including normal CSF findings and low-positive serum IgG borrelia antibody titres (IFT; ELISA). Three patients without sequelae exhibited persistent intrathecal secretion of oligoclonal B. burgdorferi-specific CSF IgG antibodies (Immunoblot; positive borrelia CSF IgG antibody titres). Thirteen patients exhibited mild-to-medium sequelae with persistent intrathecal formation of oligoclonal B. burgdorferi-specific CSF IgG antibodies, up to 21 years after the acute illness. This persistence can be interpreted as an “immunological scar syndrome.” Our follow-up studies appear to indicate that neurological manifestations of B. burgdorferi infections are generally (with few exceptions) of a benign nature. Most patients can be classified as having been cured without antibiotic therapy. No late manifestations of chronic progressive CNS borreliosis comparable to that of neurosyphilis have been seen following acute untreated neuroborreliosis.

Symptoms:

Symptoms may include:

    Fever and chills.

  • Mental status changes.

  • Nausea and vomiting.

  • Sensitivity to light (photophobia).

  • Severe headache.

  • Stiff neck (meningismus)

Other symptoms that can occur with this disease:

    Agitation.

  • Bulging fontanelles.

  • Decreased consciousness.

  • Opisthotonos.

  • Poor feeding or irritability in children.

  • Rapid breathing.

Diagnosis:

Your doctor may order one of several tests to determine if you have lymphocytic meningoradiculitis. These include:

Blood tests (hemoculture) - These tests may determine bacterial strains that have entered the blood stream, and may be causing bacterial meningitis.

DNA tests - Called a polymerase chain reaction analysis (PCR), this DNA test looks for certain causes of lymphocytic meningoradiculitis.

Imaging tests - Computerized tomography (CT scans) or x-rays look for inflammation in the chest, sinuses, skull, and other areas of the body associated with lymphocytic meningoradiculitis.

Spinal tap (lumbar puncture) - During this procedure, your cerebrospinal fluid is collected, and analyzed for low sugar, increased protein, and increased white blood cells. These are indicative of lymphocytic meningoradiculitis. Additionally, this test may allow the doctor to culture the specific type of bacterial strain that may be causing the meningitis, allowing for better treatment. This test may take a relatively long period of time: up to one week. However, a new test--Xpert EV test--allows results in less than 3 hours for 90% of viral lymphocytic meningoradiculitis. A negative test may indicate bacterial meningitis, while a positive test indicates viral meningitis.

Throat culture - This test can identify the bacterial strain causing headache, neck pain, and throat pain, but does not determine what bacteria may be in your cerebrospinal fluid.

Treatment:

There is currently no known cure. Only a doctor will be able to determine what type of lymphocytic meningoradiculitis you have, and the appropriate treatment. If you are in close contact with someone who has lymphocytic meningoradiculitis, talk with your doctor so that you can take medication - if necessary - to avoid contracting lymphocytic meningoradiculitis yourself. In generally, treatments for lymphocytic meningoradiculitis vary depending upon the cause. Ultimately, the goal of treatment will be to allow for recovery, and to reduce complications. Let's take a look at possible treatments for lymphocytic meningoradiculitis now.

For most people, the condition improves over time. Researchers found that over half of patients stop feeling pain within one year. In many cases, it may take a combination of treatments to reduce the pain.

Anticonvulsant drugs, usually used for seizures, may help with the pain of damaged nerves. Gabapentin and pregabalin are the ones most commonly used to treat postherpetic neuralgia. Skin patches with lidocaine may also be prescribed to relieve some of the pain for a period of time.

Pain medications are often needed. Sometimes acetaminophen or NSAIDs such as ibuprofen are enough. Many patients will need stronger, prescription drugs such as codeine, hydrocodone, oxycodone.

Drugs used to treat depression (antidepressants) may also help reduce pain, as well as help with sleep.

Electrical nerve stimulators may be used for severe, long-term cases of postherpetic neuralgia.

Side effects: Positive.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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