Comparison of clinical differences between American and European LNB*

Manifestations of Lyme Borreliosis
LNBAmerican LNBEuropean LNB
SubspeciesB burgdorferi sensu strictoB garinii > B afzelii
Painful radiculitis<10%>50%
Aseptic meningitis at presentationMajorityMinority
Intrathecal antibodiesMinority>50%
Cranial neuropathyVII, rarely othersVII and others
Chronic encephalomyeloradiculitis<0.1%Unusual, <3%
Erythema migransCommon, <5 cm erythematous patch at the site of tick biteUncommon
Chronic skin manifestationsNever10% Acrodermatitis chronica atrophicans: chronic extensor surface discoloration
± Swelling
± Associated peripheral neuropathy
Associated Lyme arthritisCommon, pauciarticular; knees ∼50%, weeks-to-months postinfectionRare
CarditisHeart block, transient possible perimyocarditisRare
  • Note:—LD indicates Lyme disease; LNB, Lyme neuroborreliosis.

  • * Adapted from Pachner and Steiner,8 Hengge et al,16 and Stanek.22