Koch J, Klotz J M, Langohr H D
Klinik für Neurologie und Neurophysiologie im Städt. Klinikum Fulda.
Fortschr Neurol Psychiatr. 1995 Sep;63(9):358-62. doi: 10.1055/s-2007-996636.
Whereas the diagnosis of acute neuroborreliosis by considering clinical and cerebrospinal fluid parameters is very reliable chronic neuroborreliosis is an excluding diagnosis. The clinical symptoms are uncharacteristic, and there is no reliable laboratory test permitting a safe diagnosis. Serological evidence of antibodies is no sign of activity of disease. Development of chronic infection after adequate treatment of acute neuroborreliosis seems to be very rare. We reinvestigated 15 patients half a year after antibiotic therapy of acute neuroborreliosis with regard to clinical and laboratory parameters. Most patients had a continuous intrathecal IgG antibody production against Borrelia burgdorferi, whereas no clinical signs of chronic neuroborreliosis existed. The antibody production against Borrelia burgdorferi must not be regarded as a sign of chronic infection.
虽然通过综合临床和脑脊液参数诊断急性神经型莱姆病非常可靠，但慢性神经型莱姆病是一种排除性诊断。其临床症状不典型，且没有可靠的实验室检查能做出明确诊断。血清学抗体证据并非疾病活动的迹象。急性神经型莱姆病经充分治疗后发生慢性感染的情况似乎非常罕见。我们在急性神经型莱姆病抗生素治疗半年后，对15例患者的临床和实验室参数进行了再次调查。大多数患者持续产生针对伯氏疏螺旋体的鞘内IgG抗体，而不存在慢性神经型莱姆病的临床症状。针对伯氏疏螺旋体的抗体产生不能被视为慢性感染的迹象。
