Department of Neurosciences, Overlook Medical Center, 99 Beauvoir Avenue, Summit, NJ 07902, USA; Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA.
Neurol Clin. 2018 Nov;36(4):821-830. doi: 10.1016/j.ncl.2018.06.006.
Neurologic manifestations of nervous system infection with Borrelia burgdorferi, Borrelia garinii, and Borrelia afzelii are qualitatively similar, and include lymphocytic meningitis, cranial neuritis, radiculoneuritis, and other focal or multifocal mononeuropathies. Parenchymal central nervous system (CNS) infection occurs rarely. Neurobehavioral changes are common, but are rarely evidence of CNS infection. Diagnosis requires likely exposure and a finding with high diagnostic positive predictive value, specifically erythema migrans, or laboratory support, typically positive 2-tiered serologic testing. CNS infection is often evidenced by a cerebrospinal fluid pleocytosis and intrathecal production of specific antibody.
神经系统感染伯氏疏螺旋体、伽氏疏螺旋体和阿弗西莱疏螺旋体的神经学表现基本相同，包括淋巴细胞性脑膜炎、颅神经炎、神经根神经炎和其他局灶性或多灶性单神经病。实质中枢神经系统（CNS）感染很少见。神经行为改变很常见，但很少是 CNS 感染的证据。诊断需要有明确的暴露史和具有高诊断阳性预测值的发现，具体为游走性红斑，或实验室支持，通常为 2 级血清学检测阳性。CNS 感染通常表现为脑脊液白细胞增多和鞘内产生特异性抗体。
