| Dattwyler 1988 |
This study focused only on late LB (all types, not specifically neurological). |
| Dattwyler 2005a |
This open randomized clinical trial compared 14 and 28 days of ceftriaxone treatment in people with LB including LNB. As LNB participants were not separately documented, we excluded the trial from the review. |
| Hassler 1990 |
Excluded for 2 main reasons: clear objective evidence of neurological disease was lacking, and participants were a mixed population with manifestations of joint involvement with or without peripheral nerve involvement, which was poorly documented. We contacted the author, who was unable to retrieve study data from an outdated digital storing system for further analysis. |
| Massarotti 1992 |
Participants had erythema migrans, not untreated LNB. Excluded as the objective of the review was not to determine the efficacy of antibiotic treatment of erythema migrans to prevent the development of LNB. |
| Oksi 1998 |
The manuscript did not allow for the separation of LNB from other cases of disseminated LB, although the trial authors claim that most participants had neurological symptoms. Antibiotic pretreatment in a subgroup (the trial author mentions 6 cases in each arm) prevents determination of efficacy of the initial intervention. The lack of intrathecal production of Ab in the majority of participants is surprising for European LNB (the first author himself found intrathecal antibody production in about 50% of LNB participants in a later study). Pleocytosis of the CSF is not mentioned. Being a mixture of different manifestations of stage II and III Lyme disease, the LNB cases were not sufficiently characterized for judgement of antibiotic efficacy. Most participants had CSF PCR performed, but only 1 or 2 in each group were found to be positive, suggesting that many participants may not have had active LNB, but sequelae from previously treated disease. This is consistent with the observed low response rate to antibiotic therapy in both arms, as the participants were likely selected for failure to respond to earlier treatment and by persisting symptoms (fibromyalgia, “arthritis” not otherwise defined). Although symptoms are categorized, it is unclear which symptoms were presenting at time of the study or at onset (and before any antibiotic therapy). |
| Pfister 1988 |
This was a randomized study of treatment of LNB with a non‐antibiotic intervention (corticosteroid). |
