Knudtzen FC, et al. – Authors in this work aimed to enhance the knowledge about the symptomatology and epidemiology of Lyme neuroborreliosis (LNB). Observations revealed an association between treatment delay and residual symptoms and the lack of improvement in treatment delay during the study period, that underscored the need for standardized diagnostic routines and a better follow–up for LNB patients. Findings disagreed that all patients with LNB develop positive serum Borrelia antibodies within 6 weeks after infection.

Methods

• A retrospective study was performed of all LNB cases verified by a positive Borrelia intrathecal antibody index test performed at the Department of Microbiology, Odense University Hospital, Denmark, from 1995 through 2014.

Results

• 431 patients were included; 126 were children.
• The mean incidence of 4.7 per 100 000 inhabitants per year was observed.
• In the study population, the median delay from neurological symptom debut to first hospital contact was 20 days and significantly longer for patients with symptom debut in the winter/early spring.
• Painful radiculitis (65.9%), cranial nerve palsy (43.4%), and headache (28.3%) were identified as the most common clinical symptoms.
• Authors observed a total of 30.6% in >1 hospital department, and 85.6% admissions during their course of treatment.
• In 67 patients (15.5%), serum Borrelia immunoglobulin M and immunoglobulin G at the time of positive Borrelia intrathecal antibody index test were negative.
• A median treatment delay observed was of 24 days, with no improvement in the 20–year study period.
• 28.1% of patients indicated residual symptoms following treatment, and risk of residual symptoms was markedly associated with delay from symptom debut to initiation of treatment.