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Comment & Response |

Laboratory Testing for Lyme Neuroborreliosis

Ronald Lautner, MD1; Henrik Zetterberg, MD, PhD1; Kaj Blennow, MD, PhD1
[+] Author Affiliations
1Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
JAMA Neurol. 2015;72(1):125-126. doi:10.1001/jamaneurol.2014.3552.
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To the Editor In their Viewpoint published in JAMA Neurology, Melia et al1 discussed diagnosis of Lyme disease, a tick-borne infection caused by the spirochete Borrelia burgdorferi, focusing primarily on the disease’s affliction of the central nervous system, which is a condition commonly referred to as neuroborreliosis.

When it comes to laboratory testing for neuroborreliosis, the authors particularly emphasized the usefulness and pitfalls of serologic testing including IgG and IgM immunoblots as well as assessment of the B burgdorferi antibody ratio between cerebrospinal fluid (CSF) and blood. We fully agree that serologic testing represents one of the key elements in the diagnostic workup of patients with suspected neuroborreliosis. However, we believe that in a clinical setting, additional basic CSF analyses should be taken into account along with the clinical assessment.

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January 1, 2015
Michael T. Melia, MD; Paul M. Lantos, MD; Paul G. Auwaerter, MD
1Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
2Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina3Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
JAMA Neurol. 2015;72(1):126. doi:10.1001/jamaneurol.2014.3555.
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