Central nervous system manifestations of Lyme disease

Arch Neurol. 1989 Jul;46(7):790-5. doi: 10.1001/archneur.1989.00520430086023.


We studied six patients with central nervous system manifestations of Lyme disease. Weeks to years after the initial infection, behavioral changes, ataxia, and/or weakness in bulbar or peripheral muscles developed. Four of the six patients had a lymphocytic pleocytosis in the cerebrospinal fluid, and two of them had magnetic resonance imaging scans suggestive of demyelination. In a patient with a subacute encephalitis, a brain biopsy specimen showed microgliosis without an inflammatory infiltrate and spirochetes morphologically compatible with Borrelia burgdorferi. All six patients had elevated antibody titers to B burgdorferi in serum, but none had selective concentration of specific antibody in the cerebrospinal fluid. All six patients were treated with high-dose intravenous penicillin; four had complete recoveries and two did not. Lyme disease may affect the central nervous system causing organic brain disease or syndromes suggestive of demyelination.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Central Nervous System Diseases / diagnosis*
  • Central Nervous System Diseases / etiology
  • Central Nervous System Diseases / therapy
  • Child
  • Female
  • Humans
  • Lyme Disease* / complications
  • Lyme Disease* / diagnosis
  • Lyme Disease* / therapy
  • Male
  • Middle Aged