Cerebrospinal fluid neuroborreliosis

Borreliosis is a disease that frequently and typically affects both the central and peripheral nervous systems (Table 13 for a historical overview, see Table 14). Owing to the frequent occurrence in our area, it is possible to observe highly variable clinical manifestations as well as different types of pathological appearances in cerebrospinal fluid. Current methods used in neuroborreliosis diagnosis include the evaluation of specific antibodies IgM, IgG detected by ELISA, Western blot, and PCR. 

Changes of immunoglobulin concentrations in cerebrospinal fluid are very common. In neuroborreliosis the increase occurs very frequently in the IgM class, for which it is possible (using Reiber s formula) to demonstrate the presence of intrathecal synthesis. 

Polyradiculoneuritis Guillain-Barre—the manifestation of monocytous oligocytosis is present and is practically indistinguishable from certain forms of neu-roborreliosis the syndrome of proteinocytological dissociation is also present, and it is usually distinctly expressed. The best differentiation can be obtained by the presence of an antibody response in cerebrospinal fluid in neuroborreliosis. 

We investigated 53 samples of cerebrospinal fluid (CSF) in patients with neuroborreliosis. The clinical diagnosis of neuroborreliosis was confirmed by positive antibody titers and intrathecal synthesis of immunoglobulins in CSF examined in the IgM and IgG classes by the EFISA method or Western blot or confirmed by direct detection by PCR. 

Sobek, O., Adam, R, Zeman, D., Kelbich, R, etal., Parameters of cerebrospinal fluid in patients with neuroborreliosis. Clin. Biochem. Metab. 6(27), 229-234 (1998). 

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