Halperin John J
Department of Neurosciences, Atlantic Neuroscience Institute & Overlook Hospital, Summit, NJ 07902, USA.
Infect Dis Clin North Am. 2008 Jun;22(2):261-74, vi. doi: 10.1016/j.idc.2007.12.009.
Lyme disease affects the nervous system in about 10% to 15% of infected individuals, most commonly causing lymphocytic meningitis. Cranial neuropathies, particularly facial nerve palsy, also occur frequently. Figuring prominently in the European literature, but less emphasized in the United States, is painful radiculitis, radicular pain involving a limb or trunk dermatome. Treatment of neuroborreliosis is usually straightforward; oral antibiotics may suffice in many patients. 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.
莱姆病在约10%至15%的感染个体中会影响神经系统，最常见的是引起淋巴细胞性脑膜炎。颅神经病变，尤其是面神经麻痹，也很常见。在欧洲文献中显著提及，但在美国较少被强调的是疼痛性神经根炎，即涉及肢体或躯干皮节的神经根性疼痛。神经型莱姆病的治疗通常很简单；许多患者口服抗生素可能就足够了。在严重病例中，需要进行2至4周的肠外治疗。所有现有证据表明，超过4周的治疗存在很大风险，但几乎没有额外益处。
