[Limb and joint pain in Lyme disease. An important differential neurologic diagnosis]

On the basis of 4 cases, attention is drawn to the problem of early detection of Lyme disease. The occurrence of joint pain with fluctuating spread and unresponsive to the usual antiinflammatory therapy should prompt the physician to consider lyme disease, which can be confirmed or excluded only by lumbar puncture. The CSF shows a cell count of between 300/3 and 2,000/3 cells (90% lymphocytes) and usually moderately elevated protein. A demonstration of elevated antibody titers confirms the diagnosis. The condition can be cured with antibiotics (penicillins or cephalosporins) and also cerebral nerve involvement (usual the facial nerve) with or without impairment of taste also clears up completely.