Diagnostic challenges in patients with suspected Lyme neuroborreliosis

Abstract

Lyme neuroborreliosis is a tick–borne spirochetal infection, which may affect the peripheral or central nervous system at the early or late stages of the disease. The purpose of the work is to analyze modern scientific literature on the issues of clinical manifestations, diagnostics of early and late Lyme neuroborreliosis. Analysis of the scientific literature related to the diagnosis of Lyme neuroborreliosis was carried out. According to the authors of the researches, it was found that clinical presentation varies with disease stage, and Lyme neuroborreliosis is reported in up to 25 % of patients with Lyme disease. The clinical manifestations of this not uncommon disorder nowadays depend on the neurological structures which are primarily involved. The full clinical picture of Lyme neuroborreliosis may mimic other diseases, so atypical symptoms can result in diagnostic delay or misdiagnosis. Conclusions. The incidence of Lyme neuroborreliosis seems to be much higher than previously assumed. Cerebrospinal fluid examination (detection of Borrelia burgdorferi IgM and IgG specific antibodies) is essential for the diagnosis of early and late Lyme neuroborreliosis, as successful treatment of early Lyme neuroborreliosis can prevent the expensive and devastating consequences of late Lyme neuroborreliosis.