Risk of Neurological Disorders in Patients With European Lyme Neuroborreliosis: A Nationwide, Population-Based Cohort Study

Rasmus Haahr*, Malte M Tetens, Ram B Dessau, Karen A Krogfelt, Jacob Bodilsen, Nanna S Andersen, Jens K Møller, Casper Roed, Claus B Christiansen, Svend Ellermann-Eriksen, Jette M. Bangsborg, Klaus Hansen, Thomas L Benfield, Christian Ø. Andersen, Niels Obel, Anne-Mette Lebech, Lars H Omland

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

Abstract

Background
Lyme neuroborreliosis (LNB), caused by the tick-borne spirochetes of the Borrelia burgdorferi sensu lato species complex, has been suggested to be associated with a range of neurological disorders. In a nationwide, population-based cohort study, we examined the associations between LNB and dementia, Alzheimer’s disease, Parkinson’s disease, motor neuron disease, epilepsy, and Guillain-Barré syndrome.

Methods
We used national registers to identify all Danish residents diagnosed during 1986–2016 with LNB (n = 2067), created a gender- and age-matched comparison cohort from the general population (n = 20 670), and calculated risk estimates and hazard ratios.

Results
We observed no long-term increased risks of dementia, Alzheimer’s disease, Parkinson’s disease, motor neuron diseases, or epilepsy. However, within the first year, 8 (0.4%) of the LNB patients developed epilepsy, compared with 20 (0.1%) of the comparison cohort (difference, 0.3%; 95% confidence interval, .02–.6%). In the LNB group, 11 (0.5%) patients were diagnosed with Guillain-Barré syndrome within the first year after LNB diagnosis, compared with 0 (0.0%) in the comparison cohort. After the first year, the risk of Guillain-Barré was not increased.

Conclusions
LNB patients did not have increased long-term risks of dementia, Alzheimer’s disease, Parkinson’s disease, motor neuron diseases, epilepsy, or Guillain-Barré. Although the absolute risk is low, LNB patients might have an increased short-term risk of epilepsy and Guillain-Barré syndrome.
Original languageEnglish
JournalClinical Infectious Diseases
Volume71
Issue number6
Pages (from-to)1511-1516
Number of pages6
ISSN1058-4838
DOIs
Publication statusPublished - 2020

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