Neuroborreliosis is not the same thing as late Lyme disease

[X-member]

This is from the same link that I have given you some information from a couple of times before in this topic.

http://www.efns.org/fileadmin/user_uplo ... liosis.pdf

A quote:

Duration of treatment

There are no comparative controlled studies of treatment
length in European late LNB. A recent American openlabel
randomized comparison (class III) of 14-day vs.
28-day treatment with ceftriaxone (2 g daily) for late
Lyme borreliosis (143 patients, of whom a third with
neurological symptoms) showed similar cure rates (76%
and 70%, respectively) after 1 year, and there were more
discontinuations as a result of adverse events in the 28-
day group [106]. Another series (class IV) of late LNB
showed disappearance of symptoms in 69/79 (87%) after
100 days regimens with various antibiotics, whereas
14 days with ceftriaxone cured four of 13 (31%) [107].

And now, Halperins information again:

http://www.aldf.com/pdf/Halperin_Book_Chapter_17.pdf

A quote (from: "17.6 Treatment – The Myth that More
(and more and more…) is Better"):

Numerous studies have now shown that Lyme disease – even in the presence of
nervous system infection – can readily be treated with fairly short courses of conventional antibiotics.

Does it look like Halperin is talking about late (stage 3) neuroboreliosis?

[X-member]

Information from the same link from Norway again, but this time about EARLY Lyme neuroborreliosis instead:

A quote:

However, a Finnish class II study showed no benefit of extended
treatment [100]. In this study, 152 patients with disseminated
Lyme disease (including 62 with neuroborreliosis)
were randomized to treatment of 3 weeks with
IV ceftriaxone followed by either oral amoxicillin (2 g
b.i.d.) or placebo for 100 days. At 1-year follow-up, the
groups were similar with about 90% having excellent or
good outcome.

So, in early Lyme neuroborreliosis (stage 2) it is enough with a "fairly short course" (as Halperin say) in almost all the cases.

[X-member]

I know some really stubborn people from Sweden (and I think that there are some more stubborn people in other places in this world, too) that actually think the definition neuroborreliosis (=stage 2) can be used even for late Lyme disease (=stage 3). But, haven't you (stubborn people) noticed that you only get 14 days of oral Doxy from your physician for neuroborreliosis (=stage 2), and that the treatment actually is longer for late Lyme disease (=stage 3)? (At least it is in Sweden and also in Norway if I remember correct.)

[X-member]

http://www.lymeneteurope.org/forum/view ... =10#p31339

From the topic above:

Spanky:

And that several studies show that there is no real sound basis for the rigid stage distinctions (as to neuro).

In Sweden, Denmark and Norway (and I think in most European countries):

Neuroborreliosis = early, stage 2 (easy-to-cure when it comes to treatment in most cases)

Chronic or late neuroborreliosis = an infection in CNS for more than 6 months = stage 3 (this can be more hard-to-cure when it comes to treatment)

I do not find this (the above) hard to understand.

[X-member]

Late Lyme disease or late (or chronic) Lyme borreliosis = a Lyme infection (that can be located anywhere in the body, and this do not even have to be a neuroborreliosis) that have lasted for a longer time.

Burrascano call a Lyme infection that have lasted for more than 12 months: Chronic Lyme disease (written WITHOUT quotation marks).

[X-member]

"Comparison of Findings for Patients with Borrelia garinii and Borrelia afzelii Isolated from Cerebrospinal Fluid"

http://cid.oxfordjournals.org/content/43/6/704.long

A quote:

Duration of symptoms indicating potential CNS involvement for ⩽6 months before CSF samples were examined (an arbitrary time limit for distinction between early and late Lyme neuroborreliosis) was reported more often in the B. garinii group than in the B. afzelii group (in 22 of 23 patients vs. in 3 of 10 patients).

So, can Halperins information (see earlier posts) really be correct understood in Europe?

If even late neuroborreliosis (the European definition of it, that is) is "as easy to cure" as Halperin claim, then he should have said late neuroborreliosis, shouldn't he?

But (how we in Europe read what Halperin say), he say that even a neuroborreliosis (= early/stage 2 and in most cases a rather easy-to-cure Lyme infection), is easy-to-cure.

And this (at least amongst those people that know a bit more) already know , but it can confuse a lot of people that is not so very educated, like people that actually think that neuroborreliosis is another word for late (or chronic) Lyme borreliosis.

[X-member]

"Guidelines for Diagnosis and Treatment German Borreliosi"

http://www.lymeneteurope.org/forum/view ... 204#p31434

From the topic/post above (thank you, Lorima):

http://lymedisease.org/wp-content/uploa ... 774413.pdf

From the link in the quote above (page 4):

Objections to the IDSA guidelines for treatment of LD and chronic LB:

- In Europe, LD is often associated with generalized dissemination throughout the entire body, including involvement of the central nervous system (CNS). Treatment should therefore be carried out with antibiotics that penetrate the CNS, irrespective of the various manifestations of the illness (arthritis, neuroborreliosis, neuropathy, acrodermatitis, carditis, encephalopathy).

Edit to add:

But Spanky over and over again post a quote (from IDSA) "how to diagnose" early and late neuroborreliosis and when it comes to neuroborreliosis IDSA say: "differences may be related more to the degree of involvement"

[X-member]

"Chronic persistent Lyme Disease (LD) or chronic Borreliosis"

http://www.borreliose-nachrichten.de/wp ... liosis.pdf

A quote (much, much more to read on the link):

Similarily, misdiagnoses can also occur if the CSF (Cerebrospinal fluid) analysis fails to show Borrelia antibodies or inflammation markers. The same applies if the patient has been treated with Cortisone in the past after a tick bite. The lab results are therefore misleading. A case of chronic persistent Borreliosis will not show any signs of inflammation or abnormalities in the CFS after a certain period of time and ,also, not if the spirochetes haven`t been close enough to the ventricular area or the centre of the brain where the cerebrospinal fluid flows. Nevertheless, CFS is, at the moment, still the standard procedure to rule out the possibility of active Lyme Disease.

Almost all chronic and actively persistent Borrelia infections cause neurological, cognitive and psychological impairment and symptoms, therefore it would be more correct to speak of chronic Borreliosis with neuro-psychological symptoms, rather than of Neuroborreliosis, to avoid confusion with the disease pattern of acute Neuroborreliosis.

acute = early

[X-member]

One member maybe need the information in this thread, so I activate it.