Lyme neuroborreliosis: Central nervous system manifestations

John Halperin, B. J. Luft, A. K. Anand, C. T. Roque, O. Alvarez, D. J. Volkman, R. J. Dattwyler

Research output: Contribution to journalArticle

219 Citations (Scopus)

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 paychiatric 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-Bburgdorferi 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.

Original languageEnglish (US)
Pages (from-to)753-759
Number of pages7
JournalNeurology
Volume39
Issue number6
StatePublished - Jan 1 1989
Externally publishedYes

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Lyme Neuroborreliosis
Central Nervous System
Multiple Sclerosis
Brain Diseases
Meningitis
Evoked Potentials
Infection
Borrelia Infections
Oligoclonal Bands
Borrelia burgdorferi
Spinal Puncture
Central Nervous System Diseases
Psychiatry
Cerebrospinal Fluid
Anti-Idiotypic Antibodies
Immunoglobulin G

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Halperin, J., Luft, B. J., Anand, A. K., Roque, C. T., Alvarez, O., Volkman, D. J., & Dattwyler, R. J. (1989). Lyme neuroborreliosis: Central nervous system manifestations. Neurology, 39(6), 753-759.
Halperin, John ; Luft, B. J. ; Anand, A. K. ; Roque, C. T. ; Alvarez, O. ; Volkman, D. J. ; Dattwyler, R. J. / Lyme neuroborreliosis : Central nervous system manifestations. In: Neurology. 1989 ; Vol. 39, No. 6. pp. 753-759.
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Halperin, J, Luft, BJ, Anand, AK, Roque, CT, Alvarez, O, Volkman, DJ & Dattwyler, RJ 1989, 'Lyme neuroborreliosis: Central nervous system manifestations', Neurology, vol. 39, no. 6, pp. 753-759.

Lyme neuroborreliosis : Central nervous system manifestations. / Halperin, John; Luft, B. J.; Anand, A. K.; Roque, C. T.; Alvarez, O.; Volkman, D. J.; Dattwyler, R. J.

In: Neurology, Vol. 39, No. 6, 01.01.1989, p. 753-759.

Research output: Contribution to journalArticle

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Halperin J, Luft BJ, Anand AK, Roque CT, Alvarez O, Volkman DJ et al. Lyme neuroborreliosis: Central nervous system manifestations. Neurology. 1989 Jan 1;39(6):753-759.