[Neurological manifestations of Lyme disease]

Lyme's disease, transmitted by Borrelia Burgdorferi (BB), is a polymorphic and multisystemic illness. Its neurological manifestations are encountered in 10-50% of cases and occur in the acute disseminated stage as well as in the late stage. This article initially reviews the principal clinical pictures of the neuroborreliosis and distinguishes them from neurological disorders whose association with BB infection is not proven. The paper then discusses the relative usefulness of the different ancillary tests in the diagnostic workup. We hope to stimulate interest in the research of intrathecal specific antibody production (especially in the early central nervous system diseases), instead of measuring levels of anti-BB antibodies in the serum and in the cerebrospinal fluid. Finally, a treatment plan is proposed, whose efficiency constitutes another argument in favor of the correct diagnosis but whose failure may reflect a diagnostic error.