lyme neuroborreliosis

Summary

Summary: Nervous system infections caused by tick-borne spirochetes of the BORRELIA BURGDORFERI GROUP. The disease may affect elements of the central or peripheral nervous system in isolation or in combination. Common clinical manifestations include a lymphocytic meningitis, cranial neuropathy (most often a facial neuropathy), POLYRADICULOPATHY, and a mild loss of memory and other cognitive functions. Less often more extensive inflammation involving the central nervous system (encephalomyelitis) may occur. In the peripheral nervous system, B. burgdorferi infection is associated with mononeuritis multiplex and polyradiculoneuritis. (From J Neurol Sci 1998 Jan 8;153(2):182-91)

Top Publications

  1. Halperin J. Lyme disease and the peripheral nervous system. Muscle Nerve. 2003;28:133-43 pubmed
    ..The mechanism underlying these neuropathies remains unclear, although interactions between anti-Borrelia antibodies and several peripheral nerve constituent molecules raise intriguing possibilities...
  2. Ekerfelt C, Jarefors S, Tynngård N, Hedlund M, Sander B, Bergstrom S, et al. Phenotypes indicating cytolytic properties of Borrelia-specific interferon-gamma secreting cells in chronic Lyme neuroborreliosis. J Neuroimmunol. 2003;145:115-26 pubmed
    The immuno-pathogenetic mechanisms underlying chronic Lyme neuroborreliosis are mainly unknown...
  3. Vrethem M, Hellblom L, Widlund M, Ahl M, Danielsson O, Ernerudh J, et al. Chronic symptoms are common in patients with neuroborreliosis -- a questionnaire follow-up study. Acta Neurol Scand. 2002;106:205-8 pubmed
    ..Our study shows that persisting neurological symptoms are common after a neuroborreliosis infection. The pathological mechanisms that lay behind the development of chronic symptoms, however, are still uncertain. ..
  4. Agarwal R, Sze G. Neuro-lyme disease: MR imaging findings. Radiology. 2009;253:167-73 pubmed publisher
    ..In cases of nerve-root or meningeal enhancement, Lyme disease should be considered in the differential diagnosis in the proper clinical setting. ..
  5. Rupprecht T, Pfister H, Angele B, Kastenbauer S, Wilske B, Koedel U. The chemokine CXCL13 (BLC): a putative diagnostic marker for neuroborreliosis. Neurology. 2005;65:448-50 pubmed
    ..These results point to BLC as a putative additional diagnostic marker for neuroborreliosis. ..
  6. Lunemann J, Gelderblom H, Sospedra M, Quandt J, Pinilla C, Marques A, et al. Cerebrospinal fluid-infiltrating CD4+ T cells recognize Borrelia burgdorferi lysine-enriched protein domains and central nervous system autoantigens in early lyme encephalitis. Infect Immun. 2007;75:243-51 pubmed
    ..burgdorferi-specific T cells is not restricted to chronic and treatment-resistant manifestations. ..
  7. Narayan K, Dail D, Li L, Cadavid D, Amrute S, Fitzgerald Bocarsly P, et al. The nervous system as ectopic germinal center: CXCL13 and IgG in lyme neuroborreliosis. Ann Neurol. 2005;57:813-23 pubmed
    b>Lyme neuroborreliosis (LNB) is a chronic infection in which B-cell activation, plasma cell infiltration, and enhanced Ig production in infected tissue are prominent feature...
  8. Pachner A, Amemiya K, Bartlett M, Schaefer H, Reddy K, Zhang W. Lyme borreliosis in rhesus macaques: effects of corticosteroids on spirochetal load and isotype switching of anti-borrelia burgdorferi antibody. Clin Diagn Lab Immunol. 2001;8:225-32 pubmed
    ..burgdorferi IgG antibody is much more effective than IgM antibody in decreasing the spirochetal load in infected animals. ..
  9. van Burgel N, Bakels F, Kroes A, van Dam A. Discriminating Lyme neuroborreliosis from other neuroinflammatory diseases by levels of CXCL13 in cerebrospinal fluid. J Clin Microbiol. 2011;49:2027-30 pubmed publisher
    CXCL13 in cerebrospinal fluid (CSF) could be an important component for diagnosing Lyme neuroborreliosis (LNB)...

More Information

Publications90

  1. van Burgel N, Oosterloo M, Kroon F, van Dam A. Severe course of Lyme neuroborreliosis in an HIV-1 positive patient; case report and review of the literature. BMC Neurol. 2010;10:117 pubmed publisher
    b>Lyme Neuroborreliosis (LNB) in a human immunodeficiency virus (HIV) positive patient is a rare co-infection and has only been reported four times in literature...
  2. Meurs L, Labeye D, Declercq I, Piéret F, Gille M. Acute transverse myelitis as a main manifestation of early stage II neuroborreliosis in two patients. Eur Neurol. 2004;52:186-8 pubmed
  3. Cerny R, Machala L, Bojar M, Rozsypal H, Picha D. Neuroborreliosis in an HIV-1 positive patient. Infection. 2006;34:100-2 pubmed
    ..garinii. The patient was successfully treated with cefotaxime. In all published HIV+ cases, the course of borreliosis did not differ from that of the HIV negative population and the prognosis in properly treated patients was good. ..
  4. Grusell M, Widhe M, Ekerfelt C. Increased expression of the Th1-inducing cytokines interleukin-12 and interleukin-18 in cerebrospinal fluid but not in sera from patients with Lyme neuroborreliosis. J Neuroimmunol. 2002;131:173-8 pubmed
    b>Lyme neuroborreliosis is a complex disease with different clinical outcomes and where immunopathological mechanisms are probably involved...
  5. Djukic M, Schmidt Samoa C, Nau R, von Steinbuchel N, Eiffert H, Schmidt H. The diagnostic spectrum in patients with suspected chronic Lyme neuroborreliosis--the experience from one year of a university hospital's Lyme neuroborreliosis outpatients clinic. Eur J Neurol. 2011;18:547-55 pubmed publisher
    ..burgdorferi (BB) serum antibodies in patients with non-specific symptoms and suspected chronic Lyme neuroborreliosis (LNB) are scarce. In this study, we enrolled within 1 year 122 patients with suspected chronic LNB...
  6. Ljøstad U, Skogvoll E, Eikeland R, Midgard R, Skarpaas T, Berg A, et al. Oral doxycycline versus intravenous ceftriaxone for European Lyme neuroborreliosis: a multicentre, non-inferiority, double-blind, randomised trial. Lancet Neurol. 2008;7:690-5 pubmed publisher
    Use of intravenous penicillin and ceftriaxone to treat Lyme neuroborreliosis is well documented, although oral doxycycline could be a cost-effective alternative...
  7. Dotevall L, Hagberg L, Karlsson J, Rosengren L. Astroglial and neuronal proteins in cerebrospinal fluid as markers of CNS involvement in Lyme neuroborreliosis. Eur J Neurol. 1999;6:169-78 pubmed
    Is Lyme neuroborreliosis, even in its early phase, a parenchymatous disorder in the central nervous system (CNS), and not merely a meningitic process? We quantified cerebrospinal fluid (CSF) levels of four nerve and glial cell marker ..
  8. Miklossy J, Kasas S, Zurn A, McCall S, Yu S, McGeer P. Persisting atypical and cystic forms of Borrelia burgdorferi and local inflammation in Lyme neuroborreliosis. J Neuroinflammation. 2008;5:40 pubmed publisher
    ..We investigated whether a similar situation may occur in Lyme neuroborreliosis. Atypical forms of Borrelia burgdorferi spirochetes were induced exposing cultures of Borrelia burgdorferi ..
  9. Elamin M, Monaghan T, Mulllins G, Ali E, Corbett Feeney G, O Connell S, et al. The clinical spectrum of Lyme neuroborreliosis. Ir Med J. 2010;103:46-9 pubmed
    ..Neuroborreliosis needs to be considered in the differential diagnosis of these neurological syndromes in the appropriate clinical context. ..
  10. Steiner I. Treating post Lyme disease: trying to solve one equation with too many unknowns. Neurology. 2003;60:1888-9 pubmed
  11. van Burgel N, Brandenburg A, Gerritsen H, Kroes A, van Dam A. High sensitivity and specificity of the C6-peptide ELISA on cerebrospinal fluid in Lyme neuroborreliosis patients. Clin Microbiol Infect. 2011;17:1495-500 pubmed publisher
    b>Lyme neuroborreliosis (LNB) is a serious but treatable disease. The diagnosis of LNB poses a challenge to clinicians, and improved tests are needed. The C6-peptide ELISA is frequently used on serum but not on cerebrospinal fluid (CSF)...
  12. Bernardino A, Myers T, Alvarez X, Hasegawa A, Philipp M. Toll-like receptors: insights into their possible role in the pathogenesis of lyme neuroborreliosis. Infect Immun. 2008;76:4385-95 pubmed publisher
    b>Lyme neuroborreliosis is likely caused by inflammatory effects of the tick-borne spirochete Borrelia burgdorferi on the nervous system...
  13. Skogman B, Croner S, Nordwall M, Eknefelt M, Ernerudh J, Forsberg P. Lyme neuroborreliosis in children: a prospective study of clinical features, prognosis, and outcome. Pediatr Infect Dis J. 2008;27:1089-94 pubmed publisher
    ..Persistent nonspecific symptoms, such as headache and fatigue, were not more frequently reported in patients than in controls. ..
  14. Djukic M, Schmidt Samoa C, Lange P, Spreer A, Neubieser K, Eiffert H, et al. Cerebrospinal fluid findings in adults with acute Lyme neuroborreliosis. J Neurol. 2012;259:630-6 pubmed publisher
    ..white cell count in the CSF and typical clinical symptoms is the traditional diagnostic gold standard of Lyme neuroborreliosis (LNB)...
  15. Ramesh G, Alvarez A, Roberts E, Dennis V, Lasater B, Alvarez X, et al. Pathogenesis of Lyme neuroborreliosis: Borrelia burgdorferi lipoproteins induce both proliferation and apoptosis in rhesus monkey astrocytes. Eur J Immunol. 2003;33:2539-50 pubmed
    ..Our results provide proof of the principle that spirochetal lipoproteins could be key virulence factors in Lyme neuroborreliosis, and that astrogliosis might contribute to neuroborreliosis pathogenesis.
  16. Henningsson A, Malmvall B, Ernerudh J, Matussek A, Forsberg P. Neuroborreliosis--an epidemiological, clinical and healthcare cost study from an endemic area in the south-east of Sweden. Clin Microbiol Infect. 2010;16:1245-51 pubmed publisher
    ..CSF analysis is necessary for the diagnosis of NB, because some patients develop antibodies in serum later than in CSF. Early diagnosis of borreliosis would result in reduced human suffering and in economic gain. ..
  17. Ornstein K, Berglund J, Bergstrom S, Norrby R, Barbour A. Three major Lyme Borrelia genospecies (Borrelia burgdorferi sensu stricto, B. afzelii and B. garinii) identified by PCR in cerebrospinal fluid from patients with neuroborreliosis in Sweden. Scand J Infect Dis. 2002;34:341-6 pubmed
    ..The results of our study confirm that the use of direct molecular analytical methods for Borrelia genospecies identification in clinical specimens can provide epidemiological information additional to that obtained by culture. ..
  18. Steinbach J, Melms A, Skalej M, Dichgans J. Delayed resolution of white matter changes following therapy of B burgdorferi encephalitis. Neurology. 2005;64:758-9 pubmed
  19. Krupp L, Hyman L, Grimson R, Coyle P, Melville P, Ahnn S, et al. Study and treatment of post Lyme disease (STOP-LD): a randomized double masked clinical trial. Neurology. 2003;60:1923-30 pubmed
  20. Massengo S, Bonnet F, Braun C, Vital A, Beylot J, Bastard J. Severe neuroborreliosis: The benefit of prolonged high-dose combination of antimicrobial agents with steroids--an illustrative case. Diagn Microbiol Infect Dis. 2005;51:127-30 pubmed
    ..A severe case is reported combining an encephalomyelitis with an axonal polyneuropathy. Clinical improvement was observed only with the use of prolonged high dose of 2 antimicrobial agents combined with steroids. ..
  21. Henningsson A, Ernerudh J, Sandholm K, Carlsson S, Granlund H, Jansson C, et al. Complement activation in Lyme neuroborreliosis--increased levels of C1q and C3a in cerebrospinal fluid indicate complement activation in the CNS. J Neuroimmunol. 2007;183:200-7 pubmed
    ..This finding indicates that complement plays a role in the human immune response in neuroborreliosis, that the immunologic process is compartmentalized to the CNS, and that complement activation may occur via the classical pathway...
  22. Widhe M, Jarefors S, Ekerfelt C, Vrethem M, Bergstrom S, Forsberg P, et al. Borrelia-specific interferon-gamma and interleukin-4 secretion in cerebrospinal fluid and blood during Lyme borreliosis in humans: association with clinical outcome. J Infect Dis. 2004;189:1881-91 pubmed
    ..The present data suggest that an initial IFN- gamma response, followed by up-regulation of IL-4, is associated with nonchronic manifestations, whereas a persistent IFN- gamma response may lead to chronic Lyme borreliosis...
  23. Mygland A, Ljøstad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol. 2010;17:8-16, e1-4 pubmed publisher
    b>Lyme neuroborreliosis (LNB) is a nervous system infection caused by Borrelia burgdorferi sensu lato (Bb).
  24. Pfister H, Rupprecht T. Clinical aspects of neuroborreliosis and post-Lyme disease syndrome in adult patients. Int J Med Microbiol. 2006;296 Suppl 40:11-6 pubmed
    ..There is no formal definition of the PLD syndrome, and its pathogenesis is unclear. Recent controlled studies do not support the use of additional antibiotics in these patients, but recommend primarily symptomatic strategies...
  25. Ramesh G, Borda J, Gill A, Ribka E, Morici L, Mottram P, et al. Possible role of glial cells in the onset and progression of Lyme neuroborreliosis. J Neuroinflammation. 2009;6:23 pubmed publisher
    b>Lyme neuroborreliosis (LNB) may present as meningitis, cranial neuropathy, acute radiculoneuropathy or, rarely, as encephalomyelitis...
  26. Widhe M, Skogman B, Jarefors S, Eknefelt M, Eneström G, Nordwall M, et al. Up-regulation of Borrelia-specific IL-4- and IFN-gamma-secreting cells in cerebrospinal fluid from children with Lyme neuroborreliosis. Int Immunol. 2005;17:1283-91 pubmed
  27. Gustaw K, Beltowska K, Studzińska M. Neurological and psychological symptoms after the severe acute neuroborreliosis. Ann Agric Environ Med. 2001;8:91-4 pubmed
    ..The results of this study suggest the existence of long-lasting consequences of acute neuroborreliosis, which can significantly influence the quality of life of patients...
  28. Abbott R, Hammans S, Margarson M, Aji B. Diaphragmatic paralysis and respiratory failure as a complication of Lyme disease. J Neurol Neurosurg Psychiatry. 2005;76:1306-7 pubmed
  29. Strle F, Ruzic Sabljic E, Cimperman J, Lotric Furlan S, Maraspin V. Comparison of findings for patients with Borrelia garinii and Borrelia afzelii isolated from cerebrospinal fluid. Clin Infect Dis. 2006;43:704-10 pubmed
    The most common cause of Lyme neuroborreliosis in Europe is Borrelia garinii, followed by Borrelia afzelii...
  30. Widhe M, Ekerfelt C, Jarefors S, Skogman B, Peterson E, Bergstrom S, et al. T-cell epitope mapping of the Borrelia garinii outer surface protein A in lyme neuroborreliosis. Scand J Immunol. 2009;70:141-8 pubmed publisher
    ..Further studies may reveal whether these epitopes can be used diagnostically and studies involving HLA interactions may show their possible pathogenetic importance...
  31. Miklossy J. Chronic inflammation and amyloidogenesis in Alzheimer's disease -- role of Spirochetes. J Alzheimers Dis. 2008;13:381-91 pubmed
  32. Cerar T, Ogrinc K, Cimperman J, Lotric Furlan S, Strle F, Ruzic Sabljic E. Validation of cultivation and PCR methods for diagnosis of Lyme neuroborreliosis. J Clin Microbiol. 2008;46:3375-9 pubmed publisher
    ..This study included 48 patients with a working clinical diagnosis of Lyme neuroborreliosis, 45 patients with a working clinical diagnosis of suspected Lyme neuroborreliosis, and a control group ..
  33. Klingebiel R, Benndorf G, Schmitt M, von Moers A, Lehmann R. Large cerebral vessel occlusive disease in Lyme neuroborreliosis. Neuropediatrics. 2002;33:37-40 pubmed
    ..previously healthy girl with an acute hemiparesis as the predominant clinical manifestation of Lyme neuroborreliosis (LNB)...
  34. Halperin J, Shapiro E, Logigian E, Belman A, Dotevall L, Wormser G, et al. Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2007;69:91-102 pubmed
    ..Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed?..
  35. Halperin J. Nervous system Lyme disease. Infect Dis Clin North Am. 2008;22:261-74, vi pubmed publisher
    ..In severe cases, 2 to 4 weeks of parenteral therapy is necessary. All available evidence indicates that treatment of more than 4 weeks' duration carries substantial risk but minimal if any additional benefit...
  36. Ljøstad U, Skarpaas T, Mygland A. Clinical usefulness of intrathecal antibody testing in acute Lyme neuroborreliosis. Eur J Neurol. 2007;14:873-6 pubmed
    ..sensitivity and temporal course of intrathecal Borrelia burgdorferi (Bb) antibody production in acute Lyme neuroborreliosis (LNB). We recruited consecutive adult patients with LNB diagnosis based on strict selection criteria...
  37. Brissette C, Houdek H, Floden A, Rosenberger T. Acetate supplementation reduces microglia activation and brain interleukin-1? levels in a rat model of Lyme neuroborreliosis. J Neuroinflammation. 2012;9:249 pubmed publisher
    ..burgdorferi-induced neuroborreliosis that is mediated in large part by a TLR2-type mechanism...
  38. Rupprecht T, Koedel U, Angele B, Fingerle V, Pfister H. [Cytokine CXCL13--a possible early CSF marker for neuroborreliosis]. Nervenarzt. 2006;77:470-3 pubmed
    ..8) and the patient responded to antibiotic therapy, thus confirming the diagnosis. In this case, measuring CXCL13 in the CSF would have led to earlier diagnosis and treatment of NB...
  39. Ramesh G, Philipp M. Pathogenesis of Lyme neuroborreliosis: mitogen-activated protein kinases Erk1, Erk2, and p38 in the response of astrocytes to Borrelia burgdorferi lipoproteins. Neurosci Lett. 2005;384:112-6 pubmed
    ..with some neurodegenerative diseases, the pathogenesis of the neurocognitive deficiencies associated with Lyme neuroborreliosis of the central nervous system also has an inflammatory component...
  40. Lepej S, Rode O, Jeren T, Vince A, Remenar A, Barsic B. Increased expression of CXCR3 and CCR5 on memory CD4+ T-cells migrating into the cerebrospinal fluid of patients with neuroborreliosis: the role of CXCL10 and CXCL11. J Neuroimmunol. 2005;163:128-34 pubmed
    ..Our results suggest that CXCL10 and CXCL11 create a chemokine gradient between the CSF and serum and recruite CXCR3-expressing memory CD4+ T-cells into the CSF of neuroborreliosis patients and that CCR5 also plays a role in this process...
  41. Eikeland R, Mygland A, Herlofson K, Ljøstad U. European neuroborreliosis: quality of life 30 months after treatment. Acta Neurol Scand. 2011;124:349-54 pubmed publisher
    The prognosis after Lyme neuroborreliosis (LNB) is debated. The aim of this study was to assess health-related Quality of Life (QoL) and neurological symptoms 30 months after treatment in European patients with LNB.
  42. Holub M, Klucková Z, Beran O, Aster V, Lobovská A. Lymphocyte subset numbers in cerebrospinal fluid: comparison of tick-borne encephalitis and neuroborreliosis. Acta Neurol Scand. 2002;106:302-8 pubmed
    ..The aim of this study was to analyze lymphocyte subset numbers in cerebrospinal fluid (CSF) from patients with tick-borne encephalitis (TBE) and acute neuroborreliosis...
  43. Bremell D, Hagberg L. Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell's palsy). BMC Infect Dis. 2011;11:215 pubmed publisher
    Bell's palsy and Lyme neuroborreliosis are the two most common diagnoses in patients with peripheral facial palsy in areas endemic for Borrelia burgdorferi...
  44. Rupprecht T, Plate A, Adam M, Wick M, Kastenbauer S, Schmidt C, et al. The chemokine CXCL13 is a key regulator of B cell recruitment to the cerebrospinal fluid in acute Lyme neuroborreliosis. J Neuroinflammation. 2009;6:42 pubmed publisher
    ..CXCL13 levels are markedly increased in the B cell-rich cerebrospinal fluid (CSF) of patients with acute Lyme neuroborreliosis (LNB), and (II) CXCL13 is released by monocytes upon recognition of borrelial outer surface proteins by ..
  45. Wutte N, Berghold A, Löffler S, Zenz W, Daghofer E, Krainberger I, et al. CXCL13 chemokine in pediatric and adult neuroborreliosis. Acta Neurol Scand. 2011;124:321-8 pubmed publisher
    Diagnosis of Lyme neuroborreliosis (NB) depends on the proof of intrathecal antibody production against Borrelia burgdorferi. CXCL13 has been seen to be elevated early in NB, before antibody production has started...
  46. Henningsson A, Tjernberg I, Malmvall B, Forsberg P, Ernerudh J. Indications of Th1 and Th17 responses in cerebrospinal fluid from patients with Lyme neuroborreliosis: a large retrospective study. J Neuroinflammation. 2011;8:36 pubmed publisher
    Previous studies indicate that successful resolution of Lyme neuroborreliosis (NB) is associated with a strong T helper (Th) 1-type cytokine response in the cerebrospinal fluid (CSF) followed by a down-regulating Th2 response, whereas ..
  47. Jarefors S, Janefjord C, Forsberg P, Jenmalm M, Ekerfelt C. Decreased up-regulation of the interleukin-12Rbeta2-chain and interferon-gamma secretion and increased number of forkhead box P3-expressing cells in patients with a history of chronic Lyme borreliosis compared with asymptomatic Borrelia-exposed indiv. Clin Exp Immunol. 2007;147:18-27 pubmed
    ..In addition, regulatory T cells might also play a role, by immunosuppression, in the development of chronic LB...
  48. Ljøstad U, Henriksen T. Management of neuroborreliosis in European adult patients. Acta Neurol Scand Suppl. 2008;188:22-8 pubmed publisher
    ..To survey present knowledge and controversies in European neuroborreliosis...
  49. Cohn K, Thompson A, Shah S, Hines E, Lyons T, Welsh E, et al. Validation of a clinical prediction rule to distinguish Lyme meningitis from aseptic meningitis. Pediatrics. 2012;129:e46-53 pubmed publisher
    ..The goal of this study was to test the performance of the Rule of 7's in a multicenter cohort of children with CSF pleocytosis...
  50. Tveitnes D, Øymar K, Natås O. Laboratory data in children with Lyme neuroborreliosis, relation to clinical presentation and duration of symptoms. Scand J Infect Dis. 2009;41:355-62 pubmed publisher
    ..01). The clinical presentation and duration of symptoms must be considered when interpreting laboratory data in children with suspected neuroborreliosis...
  51. Mattsson N, Bremell D, Anckarsäter R, Blennow K, Anckarsater H, Zetterberg H, et al. Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism. BMC Neurol. 2010;10:51 pubmed publisher
    ..We have previously found altered cerebral amyloid metabolism in other neuroinflammatory conditions. To further elucidate this, we investigated amyloid metabolism in patients with Lyme neuroborreliosis (LNB).
  52. Borg R, Dotevall L, Hagberg L, Maraspin V, Lotric Furlan S, Cimperman J, et al. Intravenous ceftriaxone compared with oral doxycycline for the treatment of Lyme neuroborreliosis. Scand J Infect Dis. 2005;37:449-54 pubmed
    ..fluid (CSF) mononuclear cell count after 10-14 d of ceftriaxone or doxycycline for treatment of Lyme neuroborreliosis. 29 patients were treated with intravenous ceftriaxone 2 g daily in Ljubljana and 36 patients with oral ..
  53. Lebech A, Hansen K, Brandrup F, Clemmensen O, Halkier Sørensen L. Diagnostic value of PCR for detection of Borrelia burgdorferi DNA in clinical specimens from patients with erythema migrans and Lyme neuroborreliosis. Mol Diagn. 2000;5:139-50 pubmed
    ..A semiquantitative detection system, representing the input amount of specific DNA and thus the density of spirochetes in clinical specimens, indicated the preferred clinical sample to obtain for PCR testing...
  54. Karkkonen K, Stiernstedt S, Karlsson M. Follow-up of patients treated with oral doxycycline for Lyme neuroborreliosis. Scand J Infect Dis. 2001;33:259-62 pubmed
    The clinical outcome for 69 patients treated with oral doxycycline for Lyme neuroborreliosis was studied retrospectively. The clinical follow-up time was 14 d to 2 y (median 7 months). All patients improved during and after treatment...
  55. Lell M, Schmid A, Stemper B, Maihofner C, Heckmann J, Tomandl B. Simultaneous involvement of third and sixth cranial nerve in a patient with Lyme disease. Neuroradiology. 2003;45:85-7 pubmed
    ..The patient was free of symptoms 1 month after completion of therapy, when thickening and contrast enhancement of the nerves were less pronounced...
  56. Pachner A, Steiner I. Lyme neuroborreliosis: infection, immunity, and inflammation. Lancet Neurol. 2007;6:544-52 pubmed
    b>Lyme neuroborreliosis (LNB), the neurological manifestation of systemic infection with the complex spirochaete Borrelia burgdorferi, can pose a challenge for practising neurologists...
  57. Van Snick S, Duprez T, Kabamba B, van de Wyngaert F, Sindic C. Acute ischaemic pontine stroke revealing lyme neuroborreliosis in a young adult. Acta Neurol Belg. 2008;108:103-6 pubmed
    ..Ischaemic CNS lesions have been rarely observed as the first manifestation of Lyme neuroborreliosis. The putative mechanism for parenchymal ischaemia is the local extension of inflammatory changes from ..
  58. Ljøstad U, Mygland A. Remaining complaints 1 year after treatment for acute Lyme neuroborreliosis; frequency, pattern and risk factors. Eur J Neurol. 2010;17:118-23 pubmed publisher
    ..To chart remaining complaints 1 year after treatment for neuroborreliosis, and to identify risk factors for a non-favorable outcome...
  59. Rupprecht T, Koedel U, Muhlberger B, Wilske B, Fontana A, Pfister H. CXCL11 is involved in leucocyte recruitment to the central nervous system in neuroborreliosis. J Neurol. 2005;252:820-3 pubmed
  60. Schmidt C, Plate A, Angele B, Pfister H, Wick M, Koedel U, et al. A prospective study on the role of CXCL13 in Lyme neuroborreliosis. Neurology. 2011;76:1051-8 pubmed publisher
    The definite diagnosis of acute Lyme neuroborreliosis (LNB) requires detection of an increased Borrelia burgdorferi-specific antibody index (AI)...
  61. Bigi S, Aebi C, Nauer C, Bigler S, Steinlin M. Acute transverse myelitis in Lyme neuroborreliosis. Infection. 2010;38:413-6 pubmed publisher
    ..Diagnosis requires clinical symptoms and evidence of inflammation within the spinal cord (cerebrospinal fluid and/or magnetic resonance imaging). ATM due to neuroborreliosis typically presents with impressive clinical manifestations...
  62. Halperin J. Nervous system Lyme disease. J R Coll Physicians Edinb. 2010;40:248-55 pubmed publisher
    ..Treatment with any of several standard regimens of oral or parenteral antimicrobials is highly effective. Prolonged treatment beyond four weeks is rarely if ever warranted, and carries significant risk...
  63. Topakian R, Stieglbauer K, Nussbaumer K, Aichner F. Cerebral vasculitis and stroke in Lyme neuroborreliosis. Two case reports and review of current knowledge. Cerebrovasc Dis. 2008;26:455-61 pubmed publisher
    We report on 2 patients with cerebral vasculitis and stroke due to Lyme neuroborreliosis (LNB)...
  64. Gooskens J, Templeton K, Claas E, van Dam A. Evaluation of an internally controlled real-time PCR targeting the ospA gene for detection of Borrelia burgdorferi sensu lato DNA in cerebrospinal fluid. Clin Microbiol Infect. 2006;12:894-900 pubmed
    ..burgdorferi sensu lato species tested. The PCR had a sensitivity of 50% in patients with neuroborreliosis. The main diagnostic role of the assay could be to confirm neuroborreliosis in patients for whom the diagnosis is doubtful...
  65. Skogman B, Glimåker K, Nordwall M, Vrethem M, Odkvist L, Forsberg P. Long-term clinical outcome after Lyme neuroborreliosis in childhood. Pediatrics. 2012;130:262-9 pubmed publisher
    To determine long-term clinical outcome in children with confirmed Lyme neuroborreliosis (LNB) and to evaluate persistent subjective symptoms compared with a control group.
  66. Bai Y, Narayan K, Dail D, Sondey M, Hodzic E, Barthold S, et al. Spinal cord involvement in the nonhuman primate model of Lyme disease. Lab Invest. 2004;84:160-72 pubmed
    ..C1q mRNA expression was significantly increased in inflamed spinal cord. This is the first comprehensive study of spinal cord involvement in Lyme borreliosis...
  67. Kaiser R. [Clinical courses of acute and chronic neuroborreliosis following treatment with ceftriaxone]. Nervenarzt. 2004;75:553-7 pubmed
    ..The prognosis of facial palsy in neuroborreliosis is quite similar to that in idiopathic facial palsy, while that in chronic neuroborreliosis largely depends on the time elapsed before diagnosis...
  68. Tjernberg I, Henningsson A, Eliasson I, Forsberg P, Ernerudh J. Diagnostic performance of cerebrospinal fluid chemokine CXCL13 and antibodies to the C6-peptide in Lyme neuroborreliosis. J Infect. 2011;62:149-58 pubmed publisher
    The aim of this study was to evaluate the chemokine CXCL13 and C6 antibodies separately and in combination in paired serum/cerebrospinal fluid (CSF) samples in the laboratory diagnosis of Lyme neuroborreliosis (LNB).
  69. Grygorczuk S, Zajkowska J, Swierzbinska R, Pancewicz S, Kondrusik M, Hermanowska Szpakowicz T. Concentration of interferon-inducible T cell chemoattractant and monocyte chemotactic protein-1 in serum and cerebrospinal fluid of patients with Lyme borreliosis. Rocz Akad Med Bialymst. 2005;50:173-8 pubmed
    ..The aim of the study was to evaluate synthesis of chemokines: interferon-induced T cell chemoattractant (I-TAC--chemoattractant for Th1 lymphocytes), and monocyte chemotactic protein (MCP-1) in Lyme borreliosis...
  70. Kondrusik M, Swierzbinska R, Pancewicz S, Zajkowska J, Grygorczuk S, Hermanowska Szpakowicz T. [Evaluation of proinflammatory cytokine (TNF-alpha, IL-1beta, IL-6, IFN-gamma) concentrations in serum and cerebrospinal fluid of patients with neuroborreliosis]. Neurol Neurochir Pol. 2004;38:265-70 pubmed
    ..The purpose of this work was to evaluate the concentration of proinflammatory cytokines: IL-1beta, IL-6, TNF-alpha, IFN-gamma in serum and cerebrospinal fluid of patients with neuroborreliosis...
  71. Blatz R, Kuhn H, Hermann W, Rytter M, Rodloff A. [Neurosyphilis and neuroborreliosis. Retrospective evaluation of 22 cases]. Nervenarzt. 2005;76:724-32 pubmed
    ..This allowed for the identification of one patient apparently infected by both Borrelia spp. and Treponema pallidum. In all cases of newly suspected neurosyphilis, we recommend considering neuroborreliosis at the same time...
  72. Miklossy J, Khalili K, Gern L, Ericson R, Darekar P, Bolle L, et al. Borrelia burgdorferi persists in the brain in chronic lyme neuroborreliosis and may be associated with Alzheimer disease. J Alzheimers Dis. 2004;6:639-49; discussion 673-81 pubmed
    ..Further in vitro and in vivo studies may bring more insight into the potential role of spirochetes in AD...
  73. Hildenbrand P, Craven D, Jones R, Nemeskal P. Lyme neuroborreliosis: manifestations of a rapidly emerging zoonosis. AJNR Am J Neuroradiol. 2009;30:1079-87 pubmed publisher
    ..Incidence, clinical manifestations, and presentations vary by geography, season, and recreational habits. Lyme neuroborreliosis (LNB) is neurologic involvement secondary to systemic infection by the spirochete Borrelia burgdorferi in ..
  74. Giunti D, Borsellino G, Benelli R, Marchese M, Capello E, Valle M, et al. Phenotypic and functional analysis of T cells homing into the CSF of subjects with inflammatory diseases of the CNS. J Leukoc Biol. 2003;73:584-90 pubmed
    ..These cells are recruited into the CSF by inducible chemokines. Thus, CSF represents a transitional station for T cells trafficking to and from the NS...
  75. Brunner J, Moschovakis G, Prelog M, Walder G, Wuerzner R, Zimmerhackl L. Lyme neuroborreliosis: aetiology and diagnosis of facial palsy in children from Tyrol. Klin Padiatr. 2010;222:302-7 pubmed publisher
    b>Lyme neuroborreliosis (LNB) is the second most common manifestation of Borrelia burgdorferi sensu lato (s. l.) infection in Europe. LNB is difficult to differentiate from other aetiologies of aseptic meningitis...
  76. Pashenkov M, Teleshova N, Kouwenhoven M, Smirnova T, Jin Y, Kostulas V, et al. Recruitment of dendritic cells to the cerebrospinal fluid in bacterial neuroinfections. J Neuroimmunol. 2002;122:106-16 pubmed
    ..Regulation of DC trafficking to and from the CSF may represent a mechanism of controlling the CNS inflammation...
  77. Morgen K, Martin R, Stone R, Grafman J, Kadom N, McFarland H, et al. FLAIR and magnetization transfer imaging of patients with post-treatment Lyme disease syndrome. Neurology. 2001;57:1980-5 pubmed
    ..To determine patterns of abnormalities on cerebral MRI that may characterize subgroups of patients with post-treatment Lyme disease syndrome (PTLDS) and to help identify pathomechanisms of disease...
  78. Topakian R, Stieglbauer K, Aichner F. Unexplained cerebral vasculitis and stroke: keep Lyme neuroborreliosis in mind. Lancet Neurol. 2007;6:756-7; author reply 757 pubmed
  79. Rupprecht T, Koedel U, Fingerle V, Pfister H. The pathogenesis of lyme neuroborreliosis: from infection to inflammation. Mol Med. 2008;14:205-12 pubmed
    This review describes the current knowledge of the pathogenesis of acute Lyme neuroborreliosis (LNB), from invasion to inflammation of the central nervous system. Borrelia burgdorferi (B.b...
  80. Sjöwall J, Carlsson A, Vaarala O, Bergstrom S, Ernerudh J, Forsberg P, et al. Innate immune responses in Lyme borreliosis: enhanced tumour necrosis factor-alpha and interleukin-12 in asymptomatic individuals in response to live spirochetes. Clin Exp Immunol. 2005;141:89-98 pubmed
    ..dendritic cells (DCs) and whole blood cells from 21 patients with different clinical outcomes of Lyme neuroborreliosis were stimulated with live borrelia spirochetes...
  81. Tjernberg I, Carlsson M, Ernerudh J, Eliasson I, Forsberg P. Mapping of hormones and cortisol responses in patients after Lyme neuroborreliosis. BMC Infect Dis. 2010;10:20 pubmed publisher
    ..We therefore mapped hormone levels in patients with previous confirmed Lyme neuroborreliosis of different outcomes and compared them with a healthy control group.