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NEUROLOGY 1989;39:1118
© 1989 American Academy of Neurology

Latent Lyme neuroborreliosis

Presence of Borrelia burgdorferi in the cerebrospinal fluid without concurrent inflammatory signs

H-W. Pfister, MD, V. Preac-Mursic, MD, B. Wilske, MD, K-M. Einhäupl, MD and K. Weinberger, MD

Neurologische Klinik, University of Munich, Munich, Federal Republic of Germany (Drs. Pfister and Einhäupl)
Hals-Nasen-Ohren-Klinik, University of Munich, Munich, Federal Republic of Germany (Dr. Weinberger)
Klinikum Grosshadern, and the Max von Pettenkofer Institut, University of Munich, Munich, Federal Republic of Germany (Drs. Preac-Munic and Wilgke).

Borrelia burgdorferi, the etiologic agent of Lyme borreliosis, was isolated from the CSF of a patient with elevated serum IgG antibody titers against B burgdorferi and a history of multiple tick bites. The absence of concurrent inflammatory signs of CSF as well as intrathecal antibody production indicates a phase of latent Lyme neuroborreliosis in which no tissue infection or reaction has yet occurred. Bilateral tinnitus was the only clinical symptom in this patient. The persistence of the bilateral tinnitus after antibiotic therapy did not support a causal relationship between this symptom and the borrelial infection.

Address correspondence and reprint requests to Dr. Pfister, Neurologische Klinik, University of Munich, Klinikum Grosshadern, 8000 Munich 70, Marchioninistrasse 15, Federal Republic of Germany.

Received October 5, 1988. Accepted for publication in final form March 13, 1989.




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