How is Lyme disease of the CNS diagnosed and treated?
Serologic testing is highly accurate after 4 to 6 weeks of infection.
In CNS infection, production of anti- B. burgdorferi antibody is often demonstrable in CSF. All positive enzyme-linked immunosorbent assay results should be confirmed with Western blots to minimize false positives.
Oral or IV antimicrobials are microbiologically curative in virtually all patients, including acute European neuroborreliosis.
Some patients report fatigue and cognitive symptoms that do not improve with further antibiotics and are not evidence of continued infection.
