Risk of Neurological Disorders in Patients With European Lyme Neuroborreliosis: A Nationwide, Population-Based Cohort Study. (10th October 2019)

• Record Type: Journal Article
• Authors: Haahr, Rasmus; Tetens, Malte M; Dessau, Ram B; Krogfelt, Karen A; Bodilsen, Jacob; Andersen, Nanna S; Møller, Jens K; Roed, Casper; Christiansen, Claus B; Ellermann-Eriksen, Svend; Bangsborg, Jette M; Hansen, Klaus; Benfield, Thomas L; Andersen, Christian Ø; Obel, Niels; Lebech, Anne-Mette; Omland, Lars H
• Is Part Of: Clinical infectious diseases. Volume 71:Number 6(2020)
• Page Start: 1511
• Page End: 1516
• Publication Date: 2019-10-10
• Subjects: European Lyme neuroborreliosis -- long-term risk -- neurodegenerative disorders -- Borrelia burgdorferi -- nationwide population-based cohort study; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz997
• Languages: English
• ISSNs: 1058-4838

Abstract

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 associations 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 = 2067), created a gender- and age-matched comparison cohort from the general population (n = 20 670), and calculated risk estimates and hazard ratios. Results: We observed no long-term increased risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, or epilepsy. However, within the first year, 8 (0.4%) of the LNB patients developed epilepsy, compared with 20 (0.1%) of the comparison cohort (difference, 0.3%; 95% confidence interval, .02–.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. Conclusions: LNB patients did not have increased long-term risks of dementia, Alzheimer's disease, Parkinson's disease, motor neuron diseases, epilepsy, or Guillain-Barré. Although the absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome. Abstract : We examined the risk of neurological disorders in patients with Lyme neuroborreliosis. No increased long-term risk of neurological diseases was observed. Increased short-term risks of epilepsy and Guillain-Barré syndrome are likely to be caused by a diagnostic bias.