title: Neuroborreliosis.
abstract: Appropriate, critical application of evidence-based diagnostic criteria enables both a clear definition of what constitutes neuroborreliosis-nervous system infection with Borrelia burgdorferi sensu stricto in the US, B garinii and less commonly B. afzelii and other species in Europe-and recognition that this disorder is quite similar in Europe and the US. Most commonly evidenced by lymphocytic meningitis and/or multifocal inflammation of the peripheral (common; cranial neuropathy, radiculopathy, mononeuropathy multiplex) or central (rare) nervous system, it is readily diagnosed and highly antibiotic responsive. Encephalopathy-altered cognition or memory-can occur as part of the systemic infection and inflammatory state, but is not evidence of neuroborreliosis. Post treatment Lyme disease syndrome-persistent neurobehavioral symptoms 6 months or more after usually curative antibiotic treatment-if real and not simply an example of anchoring bias-is unrelated to neuroborreliosis. The pathophysiology of neuroborreliosis remains unclear, but appears to involve both a requirement for viable micro-organisms and significant immune amplification.
authors.affiliation: Department of Neurosciences, Overlook Medical Center, Summit, NJ, USA. john.halperin@atlantichealth.org.|Neurology and Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, USA. john.halperin@atlantichealth.org.
authors.forename: John J
authors.initials: JJ
authors.lastname: Halperin
mesh_terms: D014943:Global Health; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000175:diagnosis* / Q000453:epidemiology*; D009420:Nervous System / Q000382:microbiology* / Q000473:pathology*
keywords: B. burgdorferi; Lyme borreliosis; Lyme disease; Neuroborreliosis; Post treatment Lyme disease syndrome