Clinical usefulness of intrathecal antibody testing in acute Lyme neuroborreliosis

The aim of the study was to examine diagnostic sensitivity and temporal course of intrathecal Borrelia burgdorferi (Bb) antibody production in acute Lyme neuroborreliosis (LNB). We recruited consecutive adult patients with LNB diagnosis based on strict selection criteria. Serum and cerebrospinal fluid (CSFs) were obtained, and clinical examination was performed pre‐treatment, and 13 days and 4 months post‐treatment. Pre‐treatment positive Bb antibody index (AI) was detected in 34 of 43 (79%). All nine pre‐treatment Bb AI negative patients, and 26 of 34 pre‐treatment Bb AI positive patients reported symptom duration