DIFFERENTIAL DIAGNOSIS OF RADICULOPATHY IN LYME BORRELIOSISAND DYSTROPHIC LESIONS OF THE VERTEBRAL COLUMN

Abstract

Subjects and methods. Thirty patients, including 9 (30.0%) men and 21 (70.0%) women, with signs of radiculopathy (RP) in late-stages Lyme borreliosis (LB) were examined. A control group comprised 30 patients with vertebrogenic RP in the presence of dystrophic changes in the vertebral column. Results. 56.7% of the patients with LB were observed to have its primary chronic course in the absence of the acute period of LB. The latter with the signs of RP showed a topic association between the pain location and the tick bite site in 43.3% of the patients. A gradual disease development was more frequently (63.3%) observed in LB while the periods of remission and exacerbation were more typical (56.7%) in vertebrogenic RP. In the patients with LB, pain syndrome depended on posture and physical exercise less frequently (30.0%) than in those with vertebrogenic RP (96.7%). Bilateral pain irradiation was more characteristic of RP in LB than in dystrophic lesions of the vertebral column. The symptoms of tonic muscle tension and limited movement volume in the afflicted part of the vertebral column were significantly less common in the patients with LB than in those with vertebrogenic RP. LB was marked by a concomitance of radicular and polyneuritic disorders (83.3%) and vertebrogenic RP was characterized by a preponderance of the radicular-type of sensitivity disorder (100%). Systemic inflammatory syndrome and polysystemacy of manifestations were more characteristic of LB. The benefits of nonsteriodal antiinflammatory drugs in LB patients with RP were significantly worse than in those with vertebrogenic RP; regression of symptoms in LB was seen only after a course of specific antibiotic therapy.

Keywords

• lyme borreliosis
• dystrophic lesions of the vertebral column
• neuroborreliosis
• radiculopathy