Motor and sensory polyneuritis with distal conduction failure as uncommon complication of an acute Rickettsia conorii infection

Rickettsia conorii is endemic in the Mediterranean region. Infections are mostly benign and neurological involvement is unusual. We describe a case of a man who presented with acute facial nerve palsy followed by flaccid tetraparesis due to an electrophysiologically established polyneuritis with dis...

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Bibliographic Details
Published in:Journal of the neurological sciences 2005-07, Vol.234 (1), p.113-116
Main Authors: Spengos, Konstantinos, Stouraitis, Georgios, Voumvourakis, Konstantinos, Zambelis, Thomas, Karandreas, Nikolaos
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Antibodies, Bacterial - isolation & purification
Biological and medical sciences
Distal conduction failure
Doxycycline - therapeutic use
Evoked Potentials, Motor - drug effects
Evoked Potentials, Motor - physiology
Evoked Potentials, Somatosensory - drug effects
Evoked Potentials, Somatosensory - physiology
Facial nerve palsy
Human viral diseases
Humans
Immunoglobulin M - metabolism
Infectious diseases
Male
Medical sciences
Mediterranean spotted fever
Neural Conduction - drug effects
Neural Conduction - physiology
Neuritis - etiology
Neuritis - microbiology
Neurology
Polyneuritis
Rickettsia conorii
Rickettsia Infections - complications
Rickettsia Infections - drug therapy
Rickettsia Infections - immunology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral diseases of the nervous system
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Summary:Rickettsia conorii is endemic in the Mediterranean region. Infections are mostly benign and neurological involvement is unusual. We describe a case of a man who presented with acute facial nerve palsy followed by flaccid tetraparesis due to an electrophysiologically established polyneuritis with distal conduction failure. Elevated IgM antibody titres for R. conorii were documented by indirect immunofluorescent antibody test. After doxycycline therapy, the patient presented a rapid clinical improvement. Repeated electrophysiological examinations revealed significantly restored compound muscles, and sensory action potentials, corresponding to the clinical course after treatment and ex juvantibus, indicate the causative relation between R. conorii infection and the described clinical syndrome.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2005.03.045