Abstract：
OBJECTIVE: The aim of this neurophysiological study was to retrospectively analyze visual evoked potentials (VEPs) acquired during an examination for diagnosing optic nerve involvement in patients with Lyme neuroborreliosis (LNB). Attention was focused on LNB patients with peripheral facial palsy (PFP) and optic nerve involvement.
METHODS: A total of 241 Czech patients were classified as having probable/definite LNB (193/48); of these, 57 were younger than 40 years, with a median age of 26.3 years, and 184 were older than 40 years, with a median age of 58.8 years. All patients underwent pattern-reversal (PVEP) and motion-onset (MVEP) VEP examinations.
RESULTS: Abnormal VEP results were observed in 150/241 patients and were noted more often in patients over 40 years (p = 0.008). Muscle/joint problems and paresthesia were observed to be significantly more common in patients older than 40 years (p = 0.002, p = 0.030), in contrast to headache and decreased visual acuity, which were seen more often in patients younger than 40 years (p = 0.001, p = 0.033). Peripheral facial palsy was diagnosed in 26/241 LNB patients. Among patients with PFP, VEP peak times above the laboratory limit was observed in 22 (84.6%) individuals. Monitoring of patients with PFP and pathological VEP showed that the adjustment of visual system function occurred in half of the patients in one to more years, in contrast to faster recovery from peripheral facial palsy within months in most patients.
CONCLUSIONS: In LNB patients, VEP helps to increase sensitivity of an early diagnostic process.
METHODS: A total of 241 Czech patients were classified as having probable/definite LNB (193/48); of these, 57 were younger than 40 years, with a median age of 26.3 years, and 184 were older than 40 years, with a median age of 58.8 years. All patients underwent pattern-reversal (PVEP) and motion-onset (MVEP) VEP examinations.
RESULTS: Abnormal VEP results were observed in 150/241 patients and were noted more often in patients over 40 years (p = 0.008). Muscle/joint problems and paresthesia were observed to be significantly more common in patients older than 40 years (p = 0.002, p = 0.030), in contrast to headache and decreased visual acuity, which were seen more often in patients younger than 40 years (p = 0.001, p = 0.033). Peripheral facial palsy was diagnosed in 26/241 LNB patients. Among patients with PFP, VEP peak times above the laboratory limit was observed in 22 (84.6%) individuals. Monitoring of patients with PFP and pathological VEP showed that the adjustment of visual system function occurred in half of the patients in one to more years, in contrast to faster recovery from peripheral facial palsy within months in most patients.
CONCLUSIONS: In LNB patients, VEP helps to increase sensitivity of an early diagnostic process.
摘要：
目的：这项神经生理学研究的目的是回顾性分析莱姆病（LNB）患者在诊断视神经受累的检查中获得的视觉诱发电位（VEP）。注意力集中在周围性面神经麻痹（PFP）和视神经受累的LNB患者上。
方法：共有241名捷克患者被归类为可能/明确的LNB（193/48）；其中，57岁小于40岁，平均年龄为26.3岁，184人年龄超过40岁，平均年龄为58.8岁。所有患者均接受了模式逆转（PVEP）和运动发作（MVEP）VEP检查。
结果：在150/241例患者中观察到异常的VEP结果，并且在40岁以上的患者中更常见（p=0.008）。观察到肌肉/关节问题和感觉异常在40岁以上的患者中更为常见（p=0.002，p=0.030），与头痛和视力下降相反，在40岁以下的患者中更常见（p=0.001，p=0.033）。在26/241LNB患者中诊断出周围性面神经麻痹。在PFP患者中，在22人（84.6％）中观察到VEP峰值时间高于实验室极限。对PFP和病理性VEP患者的监测表明，有一半的患者在一年至一年以上的时间内发生了视觉系统功能的调整，相比之下，大多数患者在几个月内从周围性面神经麻痹中恢复得更快。
结论：在LNB患者中，VEP有助于提高早期诊断过程的灵敏度。
方法：共有241名捷克患者被归类为可能/明确的LNB（193/48）；其中，57岁小于40岁，平均年龄为26.3岁，184人年龄超过40岁，平均年龄为58.8岁。所有患者均接受了模式逆转（PVEP）和运动发作（MVEP）VEP检查。
结果：在150/241例患者中观察到异常的VEP结果，并且在40岁以上的患者中更常见（p=0.008）。观察到肌肉/关节问题和感觉异常在40岁以上的患者中更为常见（p=0.002，p=0.030），与头痛和视力下降相反，在40岁以下的患者中更常见（p=0.001，p=0.033）。在26/241LNB患者中诊断出周围性面神经麻痹。在PFP患者中，在22人（84.6％）中观察到VEP峰值时间高于实验室极限。对PFP和病理性VEP患者的监测表明，有一半的患者在一年至一年以上的时间内发生了视觉系统功能的调整，相比之下，大多数患者在几个月内从周围性面神经麻痹中恢复得更快。
结论：在LNB患者中，VEP有助于提高早期诊断过程的灵敏度。
