Acute polyradiculoneuritis syndrome: clinical observations and differential diagnosis [important to rule out Lyme disease].

Authors: Supanc V, Stojić I, Vargek-Solter V, Breitenfeld T,
Roje-Bedeković M and Demarin V

Citation: Acta Clin Croat 2012(Jun); 51(2): 195-9.

Location: University Department of Neurology, Sestre milosrdnice
University Hospital Center, Zagreb, Croatia. visnjasupanc [at] inet [dot] hr

Guillain-Barré syndrome (GBS) and neuroborreliosis may clinically
manifest with symptoms related to acute polyradiculoneuritis. The aim
and purpose of this study was analysis of clinical picture in patients
with acute polyradiculoneuritis and their differential diagnosis into
patients with GBS or meningoradiculoneuritis within the framework of
neuroborreliosis. In this retrospective study, medical records of
patients with acute polyradiculoneuritis hospitalized at University
Department of Neurology, Sestre milosrdnice University Hospital Center
during a 4-year period were analyzed.

The study included data on 27 patients. Definitive diagnosis of GBS was
made in 23 patients and of neuroborreliosis in four (14.8%) patients.
Acute inflammatory demyelinating polyneuropathy was recorded in 69% of
GBS patients, Miller Fisher syndrome in four patients, and acute motor
axonal neuropathy and/or acute motor and sensory axonal neuropathy in
three patients.

Clinically, patients with neuroborreliosis manifested flaccid
tetraparesis, peripheral facial nerve paresis, bulbar paresis, ocular
motility disorders, and sensory symptoms of radicular pain and
paresthesias. Considering the relatively high prevalence of
neuroborreliosis in north-west Croatia, it is important to exclude
meningoradiculoneuritis caused by Borrelia burgdorferi on differential
diagnosis of GBS in these patients.