Central Nervous System Involvement in Lyme Disease - Making the Diagnosis and Choosing the Correct Treatment

Lyme disease is a tick-borne systemic illness caused by three pathogenic species of the spirochete Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. afzelii and B. garinii). They are flagellated bacteria close to Treponema pallidum, the ethiologic agent of syphilis. All three pathogenic species occur in Europe, Ixodes ricinus being the tick responsible for their transmission in this area. Two of the Borrelia species (B. afzelii and B. garinii) have been identified in Asia. B. burgdorferi is the sole cause of the disease in the United States. Although in United States the proportion of neuroborreliosis among Lyme disease manifestations is of about 8%, in Europe the incidence of this form of disease is more elevated 16-46% (1).