Successful treatment of lyme encephalopathy with intravenous ceftriaxone

The efficacy of intravenous ceftriaxone, 2 g per day for 30 days, was evalu ated in a case series of 18 consecutive patients who met strict criteria fo r Lyme encephalopathy. Months to years after classic manifestations of Lyme disease, the 18 patients presented with memory difficulty, minor depressio n, somnolence, or headache. Sixteen (89%) had abnormal memory scores; 16 (8 9%) had cerebrospinal fluid (CSF) abnormalities, and all 7 patients tested had frontotemporal perfusion defects on single photon emission computed tom ographic (SPECT) imaging. Six months after treatment, memory scores in the 15 patients who completed the study according to protocol were significantl y improved (P < .01). In the 10 patients who had follow-up CSF analyses, to tal protein levels were significantly lower (P < .05). In the 7 patients wh o had SPECT imaging, posttreatment perfusion was significantly better (P < .01). Twelve to 24 months after treatment, all 18 patients rated themselves as back to normal or improved. We conclude that Lyme encephalopathy can be treated successfully with ceftriaxone.