Nervous system Lyme disease

Infect Dis Clin North Am. 2015 Jun;29(2):241-53. doi: 10.1016/j.idc.2015.02.002.

Abstract

Lymphocytic meningitis, cranial neuritis or radiculoneuritis occur in up to 15% of patients with untreated Borrelia burgdorferi infection. Presentations of multifocal PNS involvement can range from painful monoradiculitis to confluent mononeuropathy multiplex. Serologic testing is highly accurate after 4 to 6 weeks of infection. In CNS infection, production of anti-Bburgdorferi antibody is often demonstrable in CSF. Oral antimicrobials are microbiologically curative in virtually all patients, including acute European neuroborreliosis. Severe cases may require parenteral treatment. The fatigue and cognitive symptoms seen in some patients with extra-neurological disease are neither evidence of CNS infection nor specific to Lyme disease.

Keywords: Borrelia burgdorferi; Central nervous system; Garin-Bujadoux Bannwarth syndrome; Intrathecal antibody; Lyme disease; Nervous system; Neuroborreliosis; Peripheral nervous system.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Borrelia burgdorferi* / isolation & purification
  • Cognition Disorders / diagnosis
  • Cognition Disorders / microbiology
  • Diagnosis, Differential
  • Humans
  • Lyme Neuroborreliosis / diagnosis*
  • Lyme Neuroborreliosis / drug therapy
  • Memory Disorders / diagnosis
  • Memory Disorders / microbiology

Substances

  • Anti-Bacterial Agents