Avtor/Urednik		Tavčar, R
Naslov		Bipolarna motnja razpoloženja ali Lymska borelioza? Prikaz bolnice
Prevedeni naslov		Bipolar mood disorder or Lyme borreliosis? A case report
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 64, št. 6
Leto izdaje		1995
Obseg		str. 329-31
Jezik		slo
Abstrakt		Background. The skin manifestations of infection with Borrelia burgdorferi are well known. There is far less data on neurologic and especially psychiatric manifestations of Lyme borreliosis. Among the latter, pseudoneurasthenic symptoms, chronic fatigue and lack of concentration are usually stated. There are some reports on psychoses during Lyme borreliosis in the current literature. Methods and results. A case report of twenty-nine years old female patient with bipolar mood disorder is given. Despite eight months of appropriate treatment with antidepressants, neuroleptics and lithium carbonate the disorder did not improve. Somatic and neurologic examinations did not reveal and pathologic condition. The same was true for routine biochemic and endocrine tests. The EEG was abnormal, but computerized tomography of brain did not show any morphological abnormality. Serologic tests found high titers of specific antibodies to Borrelia burgdorferi. The patient was treated with antibiotic ceftriaxone intravenously. After that treatment the mental state has gradually improved to complete clinic recovery. She is now taking only prophylactic treatment with the lithium carbonate. Conclusions. The author discusses some etiologic possibilities and gives a critical review of diagnostic procedure in this case.
Izvleček		Izhodišča. Že dolgo poznamo kožne spremembe pri okužbi z Borrelio burgdorferi. Manj pa so znane nevrološke in zlasti psihične spremembe. Med slednjimi se večinoma navajajo psevdonevrastenične težave, stalna utrujenost in motnje koncentracije. Šele v zadnjem času opisujejo tudi psihoze. Metode in rezultati. Predstavljen je klinični primer devetindvajsetletne bolnice, ki je kazala znake bipolarne motnje razpoloženja. Kljub ustreznemu zdravljenju z antidepresivi, nevroleptiki in litijevim karbonatom, niti po osmih mesecih ni prišlo do izboljšanja. Internistični in nevrološki pregled ni pokazal posebnosti, prav tako so bili izvidi osnovnih laboratorijskih preiskav v mejah normale, razen abnormnega EEG. Serološke preiskave so pokazale visoke titre protiteles na Borrelio burgdorferi. Računalniška tomografija možganov je bila brez posebnosti. Po parenteralnem antibiotičnem zdravljenju s ceftriaksonom se je psihično stanje postopno izboljšalo, bolnica je postala evtimna in zopet opravljala svoje delo. Od zdravil sedaj prejema le profilaktično litijev karbonat. Zaključki. Avtor razpravlja o možni etiologiji opisane motnje razpoloženja in kritično obravnava potek diagnostičnega postopka.
Deskriptorji		BIPOLAR DISORDER LYME DISEASE