Rupprecht Tobias A, Pfister Hans-Walter
Curr Probl Dermatol. 2009;37:200-206. doi: 10.1159/000213078. Epub 2009 Apr 8.
Lyme neuroborreliosis (LNB) is a tick-borne disease of the nervous system, caused by the spirochete Borrelia burgdorferi. Having entered the host at the site of the tick bite, the spirochetes can initially cause a local inflammatory reaction, called erythema migrans. If left untreated, the Borrelia can disseminate in the second stage of the disease and invade the central nervous system, causing LNB. The diagnosis of LNB is based on a compatible clinical picture (meningitis, cranial neuritis or radiculoneuritis), lymphocytic pleocytosis in the cerebrospinal fluid (CSF) and intrathecal Borrelia burgdorferi-specific antibody production. As the clinical picture of LNB may be unspecific, a lumbar puncture to analyze the CSF is usually mandatory for confirmation of the suspected diagnosis. The indications for a lumbar puncture and the limitations of the different diagnostic procedures are the main topics of this review. In addition, a short overview of the epidemiology and the therapeutic principles of LNB is given.
莱姆病神经螺旋体病（LNB）是一种由疏螺旋体伯氏疏螺旋体引起的蜱传神经系统疾病。螺旋体在蜱叮咬部位进入宿主后，最初可引起局部炎症反应，称为游走性红斑。如果不进行治疗，伯氏疏螺旋体在疾病的第二阶段可播散并侵入中枢神经系统，导致莱姆病神经螺旋体病。莱姆病神经螺旋体病的诊断基于相符的临床表现（脑膜炎、颅神经炎或神经根神经炎）、脑脊液（CSF）中的淋巴细胞增多以及鞘内产生的伯氏疏螺旋体特异性抗体。由于莱姆病神经螺旋体病的临床表现可能不具特异性，通常必须进行腰椎穿刺以分析脑脊液，以确诊疑似诊断。腰椎穿刺的指征以及不同诊断程序的局限性是本综述的主要主题。此外，还对莱姆病神经螺旋体病的流行病学和治疗原则进行了简要概述。
