Neurological manifestations of Lyme disease and treatments.

Lyme disease is a multi-systemic infection due to B. burgdorferi, with neurological manifestations observed in its second and third stages. Except for the suggestive triad meningitis--radiculoneuritis--facial palsies, the diagnosis is often difficult because of the pleiomorphism of neurological manifestations. These can be localized or diffuse, with central involvement, meningitis or peripheral manifestations. Past history, cerebrospinal fluid (CSF) examination, immuno-assays for specific antibodies in serum and especially CSF are helpful in diagnosis. Betalactam antibiotics (penicillin G, amoxicillin, and third generation cephalosporins) are the most effective treatment with good results in the early and acute stages of neurological disease.