Lyme neuroborreliosis: central nervous system manifestations.

Abstract:

:We evaluated 85 patients with serologic evidence of Borrelia burgdorferi infection. Manifestations included encephalopathy (41), neuropathy (27), meningitis (2), multiple sclerosis (MS) (6), and psychiatric disorders (3). We performed lumbar punctures in 53, brain MRI in 33, and evoked potentials (EPs) in 33. Only patients with an MS-like illness had abnormal EPs, elevated IgG index, and oligoclonal bands in the cerebrospinal fluid. Twelve of 18 patients with encephalopathy, meningitis, or focal CNS disease had evidence of intrathecal synthesis of anti-B burgdorferi antibody, compared with no patients with either MS-like or psychiatric illnesses, and only 2/24 patients with neuropathy. MRIs were abnormal in 7/17 patients with encephalopathy, 5/6 patients with an MS-like illness, and no others. We conclude that (1) intrathecal concentration of specific antibody is a useful marker of CNS B burgdorferi infection; (2) Lyme disease causes an encephalopathy, probably due to infection of the CNS; (3) MS patients with serum immunoreactivity against B burgdorferi lack evidence of CNS infection with this organism.

journal_name

Neurology

journal_title

Neurology

authors

Halperin JJ,Luft BJ,Anand AK,Roque CT,Alvarez O,Volkman DJ,Dattwyler RJ

doi

10.1212/wnl.39.6.753

subject

Has Abstract

pub_date

1989-06-01 00:00:00

pages

753-9

issue

6

eissn

0028-3878

issn

1526-632X

journal_volume

39

pub_type

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