Knudtzen FC, et al. - This study was planned to elaborate the knowledge regarding the symptomatology and epidemiology of Lyme neuroborreliosis (LNB). Findings revealed an association between treatment delay and residual symptoms and the lack of improvement in treatment delay during the study period. This underscored the necessity for standardized diagnostic routines and a better follow-up for LNB patients. As per findings, within 6 weeks after infection, all patients with LNB did not develop positive serum Borrelia antibodies.

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.
• This study indicated the mean incidence of 4.7 per 100 000 inhabitants per year.
• From neurological symptom debut to first hospital contact, the median delay was 20 days; patients with symptom debut in the winter/early spring had significantly longer median delay.
• Painful radiculitis (65.9%), cranial nerve palsy (43.4%), and headache (28.3%) were identified as the most common clinical symptoms.
• There were a total of 30.6% who were seen in >1 hospital department, and 85.6% who were admitted 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 .
• In the 20-year study period, findings revealed a median treatment delay of 24 days, with no improvement.
• Following treatment, residual symptoms were observed in 28.1% of patients.
• There appeared a significant association of risk of residual symptoms with delay from symptom debut to initiation of treatment.