Table 1. Characteristics of patients and control subjects.
| Borrelia serology (serum)* | Bb-specific intrathecal ab production* | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient no. | Diagnosis | Gender | Age (years) | Known tick-bite | Clinical EM | IgG | IgM | IgG | IgM | CSF- MNC | Neurological symptoms | Therapy | Sample in disease interval: |
| 1 | nonchronic NB | f | 40 | − | − | − | + | + | − | + | rhizopathy, neck and back pain, headache, fatigue, temperature | tetracycline | 1, 3 |
| 2 | nonchronic NB | m | 67 | + | − | ND | ND | + | − | + | muscle pain | tetracycline | 1, 2 |
| 3 | nonchronic NB | f | 40 | + | − | ND | ND | + | − | + | dizziness, paraesthesia, pain in the back, radiculitis | penicillin-V, cefotaxin, ceftriaxon | 2, 3 |
| 4 | nonchronic NB | m | 38 | − | − | ND | ND | + | + | + | meningitis, headache, stiff neck, temperature | tetracycline | 1, 2 |
| 5 | nonchronic NB | m | 52 | + | + | + | + | − | − | + | radiculitis, migrating pain, fatigue | tetracycline, ceftriaxon | 2 |
| 6 | nonchronic NB | m | 50 | + | − | ND | ND | + | + | + | lumbar pain, numbness in hands | ceftriaxon | 1, 2, 3 |
| 7 | nonchronic NB | m | 66 | + | + | + | + | − | − | + | paraesthesia, hyperaesthesia | tetracycline | 1, 2, 3 |
| 8 | nonchronic NB | m | 36 | − | − | + | + | + | − | + | muscle pain, general pain, fatigue, headache | tetracycline | 1, 2, 3 |
| 9 | nonchronic NB | m | 65 | + | − | + | + | + | − | + | paraesthesia, pain in back and legs, headache | tetracycline | 2 |
| 10 | nonchronic NB | m | 44 | − | − | + | + | + | + | + | fatigue, headache | tetracycline | 1 |
| 11 | chronic NB | m | 64 | − | − | + | − | + | − | − | fatigue, stiff neck | ceftriaxon | 1, 3 |
| 12 | chronic NB | f | 67 | + | − | + | ND | + | − | + | numbness, balance disturbances | ceftriaxon, tetracycline | 2, 3 |
| 13 | chronic NB | m | 62 | + | − | + | − | + | + | + | migrating numbness, back pain, paraesthesia | penicillin-G i.v., tetracycline i.v. | 3 |
| 14 | chronic NB | f | 50 | − | + | + | + | + | − | − | pain, fatigue | penicillin-V orally, ceftriaxon | 2, 3 |
| 15 | chronic NB | m | 35 | − | − | ND | ND | + | − | + | facial paresis, numbness, stiff neck, fatigue, neck pain | tetracycline, ceftriaxon, R+S/T | 1, 2, 3 |
| 16 | chronic NB | m | 48 | + | + | + | − | + | − | − | headache, nausea, back and shoulder pain | ceftriaxon, R + S/T | 2 |
| 17 | chronic NB | f | 49 | − | − | + | + | + | − | + | shoulder pain, impaired hearing | tetracycline, ceftriaxon, R + S/T | 2, 3 |
| 18 | chronic NB | f | 79 | + | + | + | − | + | − | + | meningitis, facial paresis, balance disturbances | ceftriaxon | 3 |
| 19 | chronic NB | f | 35 | − | − | + | − | + | − | − | dizziness, nausea, numbness | tetracycline, ceftriaxon | 2 |
| 20 | chronic NB | f | 66 | − | − | − | − | + | + | + | facial paresis, peroneal paresis | tetracycline | 1 |
| 21 | chronic NB | m | 67 | + | − | + | − | + | − | + | facial paresis, sensibility disturbances, depression, speach and visual disturbances | ceftriaxon | 3 |
| 22 | chronic NB | f | 62 | − | + | ND | ND | + | − | + | facial paresis, pain, sensibility disturbances, headache, concentration disturbances | ceftriaxon | 1 |
| 23 | chronic NB | m | 36 | − | + | ND | ND | + | − | + | radicular pain, facial paresis, sensibility disturbances, fatigue, tremor | tetracycline | 1 |
| 24 | chronic NB | f | 54 | + | + | − | − | + | + | + | acute pain in the back of the head, nausea, numbness, loss of sensibility | tetracycline, ceftriaxon | 2 |
| 25 | chronic NB | m | 63 | − | − | ND | ND | + | − | + | radicular pain, hypersensibility | tetracycline | 1 |
| 26 | EM | m | 45 | + | + | + | + | − | − | − | sciatica | tetracycline | 1, 2, 3 |
| 27 | EM | m | 54 | + | + | ND | ND | ND | ND | ND | no neurological symptoms | penicillin-V orally | 1, 2, 3 |
| 28 | EM | f | 57 | + | + | ND | ND | ND | ND | ND | no neurological symptoms | penicillin-V orally | 1, 2, 3 |
| 29 | EM | f | 60 | + | + | ND | ND | ND | ND | ND | no neurological symptoms | penicillin-V orally | 1, 2, 3 |
| 30 | EM | m | 55 | − | + | ND | ND | ND | ND | ND | no neurological symptoms | tetracycline | 2, 3 |
| 31 | EM | f | 48 | + | + | ND | ND | ND | ND | ND | no neurological symptoms | penicillin-V orally | 1, 2 |
| 32 | EM | f | 51 | − | + | ND | ND | ND | ND | ND | no neurological symptoms | penicillin-V orally | 1, 3 |
| 33 | EM | f | 40 | + | + | ND | ND | ND | ND | ND | no neurological symptoms | penicillin-V orally | 1, 2, 3 |
| 34 | control subject | f | 44 | − | − | − | − | − | − | − | no neurological symptoms | – | |
| 35 | control subject | m | 69 | − | − | − | − | − | − | − | no neurological symptoms | – | |
| 36 | control subject | f | 63 | − | − | − | − | − | − | − | no neurological symptoms | – | |
| 37 | control subject | f | 77 | − | − | − | − | − | − | − | no neurological symptoms | – | |
| 38 | control subject | f | 48 | − | − | − | − | − | − | − | no neurological symptoms | – | |
| 39 | control subject | f | 77 | − | − | − | − | − | − | − | no neurological symptoms | – | |
| 40 | control subject | f | 75 | − | − | − | − | − | − | − | no neurological symptoms | – | |
CSF, cerebrospinal fluid; EM, erythema migrans; NB, neuroborreliosis; CSF-MNC, mononuclear cells in CSF; Ig, immunoglobulin; ab, antibody; f, female; m, male; ND, not done; Bb, Borrelia burgdorferi; R + S/T, roxitromycin + sulphmetetracyclinehoxzol/trimetoprim; +, positive; –, negative.
Nonchronic NB defined as disease duration <6 months, chronic NB defined as >6 months, control subjects were patients undergoing elective orthopaedic surgery, with no known history of Borrelia infection.
Disease intervals: 1, 0–3 months; 2, >3–12 months; 3, >12 months; mononuclear pleocytosis in CSF was defined as CSF-MNC>5×106 /l.
*
Antibody analyses were performed by ELISA. B. burgdorferi-specific intrathecal antibody production refers to positive Borrelia-specific CSF antibody index according to Hansen and Lebech 1991 [17].