Copyright =A9 2002 European Federation of Chapters of the International
Association for the Study of Pain. Published by Elsevier Science Ltd.

Pain as presenting symptom in Lyme neuroborreliosis

Leif Dotevall, , a, Tore Eliassonb, Lars Hagberga and Clas Mannheimerb

a Department of Infectious Diseases, Sahlgrenska University
Hospital/=D6stra,
G=F6teborg SE-416 85, Sweden
b Department of Internal Medicine, Sahlgrenska University
Hospital/=D6stra,
G=F6teborg SE-416 85, Sweden

Received 22 March 2002;  accepted 23 October 2002. ; Available online
23
April 2003.




Abstract
Neurogenic pain with radiculitis is often the starting symptom in adult

patients with tick-borne Lyme neuroborreliosis and in some cases the
only clinical
manifestation. Cranial paresis and other neurologic signs usually occur
after
the onset of pain. The present paper describes four patients who had
severe
pain as the main presenting symptom of Lyme neuroborreliosis. Opioids
had good
short-term effect in two of the cases. Oral doxycycline treatment was
used
successfully to eliminate the infection.

Author Keywords: Lyme neuroborreliosis; Neurogenic pain; Radiculitis;
Opioid=20
treatment=20
=20

Corresponding author. Fax: +46-31-847813

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