Heller J, Holzer G, Schimrigk K
Department of Neurology, Universitätsnervenklinik, Homburg/Saar, Federal Republic of Germany.
J Neurol. 1990 Dec;237(8):465-70. doi: 10.1007/BF00314763.
Neuroborreliosis, a tick-borne spirochaetosis of the central nervous system, is diagnosed by the presence of intrathecally synthesized Borrelia burgdorferi-specific antibodies. Multiple sclerosis and neuroborreliosis can show similarities in clinical symptoms as well as lymphocytic cell reactions and oligoclonal bands in the isoelectric focusing of cerebrospinal fluid. To differentiate between multiple sclerosis and neuroborreliosis we tested intrathecally synthesized IgM and virus antibodies. The IgM indices were higher for most of the neuroborreliosis patients studied than for those with multiple sclerosis, and cell counts were also significantly higher in the acute stage of the disease. In 84% of multiple sclerosis patients we were able to demonstrate intrathecal antibody production against measles, rubella or mumps virus. Neuroborreliosis patients had no intrathecal virus antibody synthesis. The specification of oligoclonal bands resulting from isoelectric focusing of cerebrospinal fluid with an ELISA for B. burgdorferi can further substantiate the diagnosis of neuroborreliosis or help to rule it out in multiple sclerosis patients with positive borrelia-specific serology.
神经莱姆病是一种由蜱传播的中枢神经系统螺旋体病，通过鞘内合成的伯氏疏螺旋体特异性抗体来诊断。多发性硬化症和神经莱姆病在临床症状以及脑脊液等电聚焦中的淋巴细胞反应和寡克隆带方面可能表现出相似性。为了区分多发性硬化症和神经莱姆病，我们检测了鞘内合成的IgM和病毒抗体。大多数研究的神经莱姆病患者的IgM指数高于多发性硬化症患者，并且在疾病急性期细胞计数也显著更高。在84%的多发性硬化症患者中，我们能够证明鞘内产生了针对麻疹、风疹或腮腺炎病毒的抗体。神经莱姆病患者没有鞘内病毒抗体合成。用针对伯氏疏螺旋体的ELISA对脑脊液进行等电聚焦产生的寡克隆带的特异性可以进一步证实神经莱姆病的诊断，或有助于在伯氏疏螺旋体特异性血清学呈阳性的多发性硬化症患者中排除该病。
