Comparison of clinical differences between American and European LNB*
| Manifestations of Lyme Borreliosis | ||
|---|---|---|
| LNB | American LNB | European LNB |
| Subspecies | B burgdorferi sensu stricto | B garinii > B afzelii |
| LNB/LD | <10% | >35% |
| Painful radiculitis | <10% | >50% |
| Aseptic meningitis at presentation | Majority | Minority |
| Intrathecal antibodies | Minority | >50% |
| Cranial neuropathy | VII, rarely others | VII and others |
| Chronic encephalomyeloradiculitis | <0.1% | Unusual, <3% |
| Erythema migrans | Common, <5 cm erythematous patch at the site of tick bite | Uncommon |
| Chronic skin manifestations | Never | 10% Acrodermatitis chronica atrophicans: chronic extensor surface discoloration |
| ± Swelling | ||
| ± Associated peripheral neuropathy | ||
| Associated Lyme arthritis | Common, pauciarticular; knees ∼50%, weeks-to-months postinfection | Rare |
| Carditis | Heart block, transient possible perimyocarditis | Rare |
Note:—LD indicates Lyme disease; LNB, Lyme neuroborreliosis.
* Adapted from Pachner and Steiner,8 Hengge et al,16 and Stanek.22