Immunologic reactivity against Borrelia burgdorferi in patients with motor neuron disease

Arch Neurol. 1990 May;47(5):586-94. doi: 10.1001/archneur.1990.00530050110021.


Of 19 unselected patients with the diagnosis of amyotrophic lateral sclerosis (ALS) living in Suffolk County, New York (an area of high Lyme disease prevalence), 9 had serologic evidence of exposure to Borrelia burgdorferi; 4 of 38 matched controls were seropositive. Eight of 9 seropositive patients were male (8 of 12 male patients vs 2 of 24 controls). Rates of seropositivity were lower among patients with ALS from nonendemic areas. All patients had typical ALS; none had typical Lyme disease. Cerebrospinal fluid was examined in 24 ALS patients--3 (all with severe bulbar involvement) appeared to have intrathecal synthesis of anti-B burgdorferi antibody. Following therapy with antibiotics, 3 patients with predominantly lower motor neuron abnormalities appeared to improve, 3 with severe bulbar dysfunction deteriorated rapidly, and all others appeared unaffected. There appears to be a statistically significant association between ALS and immunoreactivity to B burgdorferi, at least among men living in hyperendemic areas.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis / immunology
  • Antibodies, Bacterial / analysis*
  • Antibodies, Viral / analysis
  • Borrelia burgdorferi Group / immunology*
  • Female
  • Humans
  • Lyme Disease / immunology
  • Male
  • Middle Aged
  • Motor Neurons*
  • Muscles / physiopathology
  • Nervous System / physiopathology
  • Nervous System Diseases / immunology
  • Neuromuscular Diseases / immunology*
  • Neuromuscular Diseases / physiopathology
  • Reference Values


  • Antibodies, Bacterial
  • Antibodies, Viral