![]() ![]() Some patients may present with Bannwarth syndrome, which includes painful radiculoneuritis with variable motor weakness. ![]() These symptoms can occur in any combination or alone. Neuroinvasive Lyme disease (NLD) can affect either the peripheral or central nervous system, with patients classically presenting with the triad of lymphocytic meningitis, cranial neuropathy (especially facial nerve palsy) and radiculoneuritis, which can affect the motor or sensory nerves, or both. Arthritis, cardiac disease, and neurological disease may be later stage manifestations. ![]() Other early signs and symptoms include malaise, headache, fever, lymphadenopathy, and myalgia. The classic presenting sign of early localized Lyme disease caused by B burgdorferi is erythema migrans (EM), which occurs in approximately 80% of individuals. The clinical features of Lyme disease are broad and may be confused with various immune and inflammatory disorders. Lyme disease is the most commonly reported tick-borne infection in North America and Europe, causing an estimated 300,000 cases in the United States each year and 85,000 cases in Europe. Nearly all human infections are caused by 3 Bbsl species B burgdorferi sensu stricto (hereafter referred to as B burgdorferi) is the primary cause of Lyme disease in North America, while Borrelia afzelii and Borrelia garinii are the primary causes of Lyme disease in Europe and parts of Asia. Lyme disease is a multisystem and multistage tick-transmitted infection caused by spirochetal bacteria in the Borrelia burgdorferi sensu lato (Bbsl) complex. Meningitis/Encephalitis Panel Algorithm Acute Tick-Bourne Disease Testing Algorithm Lyme Neuroborreliosis Diagnostic Algorithm The following algorithms are available in Special Instructions: This testing is performed at an additional charge. These additional tests are necessary in order to normalize the level of anti- Borrelia antibodies to total IgG and albumin in the CSF and establish the antibody index ratio of anti- Borrelia antibodies in CSF-to-serum. Anti- Borrelia species IgG levels in CSF and serum In order to establish the antibody index, the paired serum and CSF samples (collected within 24 hours of each other) are tested on the same run using quantitative assays to determine levels for the following analytes:ฤก. If the screen is positive, the paired CSF and serum specimens will be used to establish the antibody index. If the screen is negative, no additional testing will be performed. This test begins with IgG screening of the spinal fluid (CSF) specimen. ![]()
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