Abstract Details

Title Neuroborreliosis: A Retrospective Study of Clinical Manifestations and Quality of Life Impacts

Topic Infectious Disease

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-006

Background Lyme disease is an illness caused by Borrelia bacteria transmitted through tick bites. Neuroborreliosis describes Lyme disease with neurological manifestations, including cranial nerve palsies, meningitis, and radiculopathy. There is limited data on how neuroborreliosis is associated with other Lyme manifestations and measures of quality of life.

Objective This retrospective study aims to investigate the clinical, laboratory, symptom, and functional impact characteristics of patients with prior neuroborreliosis presenting for evaluation of persistent symptoms.

Design/Methods Participants presenting to the Johns Hopkins Lyme Disease Research Center for persistent symptoms following confirmed Lyme disease were included in this retrospective study. Clinical data on the patient’s medical, treatment, laboratory results, and symptoms at the onset of Lyme disease were collected via their electronic medical records or clinician encounters at the Lyme center. Surveys assessing quality of life metrics were performed at the Lyme center 6 months following initial visit.

Results In our neurological manifestation (NM) cohort consisting of 92 patients, 54.3% had cranial nerve palsies, 30.4% had neuropathy or radiculopathy, and 23.9% had Lyme meningitis. The NM group was less likely to present with diagnostic rash (35.9% vs 47.8%, p= 0.031), flu-like illness at onset (66.3% vs 79.3%, p= 0.005), and early (2.8% vs 19.8%, p<.001) or late (0% vs 7.4%, p= 0.007) Lyme arthritis than the non-NM group. The non-NM groups and the NM group showed no variations in non-Lyme related comorbidities, exposure to inappropriate antibiotic treatment (2.5% vs 2.6%, p = 0.947), or quality of life survey results.

Conclusions Our study underscores the need to investigate Lyme disease in patients with new-onset neurological manifestations, particularly in Lyme-endemic regions, irrespective of prior history of Lyme symptoms. Encouragingly, our findings suggest that patients with neurological manifestations and persistent symptoms did not exhibit worse self-assessed indicators of overall health, well-being, or functional capacity compared to the no NM cohort.

Authors/Disclosures
Anna Kolchinski PRESENTER	Ms. Kolchinski has nothing to disclose.
Ralph Habis, MD (Johns Hopkins School of Medicine)	Dr. Habis has nothing to disclose.
Alison Rebman (Johns Hopkins University)	No disclosure on file
Arun Venkatesan, MD, PhD (Johns Hopkins Hospital)	Dr. Venkatesan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Pharmaceuticals. The institution of Dr. Venkatesan has received research support from NIH. The institution of Dr. Venkatesan has received research support from MSRCF. The institution of Dr. Venkatesan has received research support from U.S. DOD.
John Aucott (Johns Hopkins)	No disclosure on file