PREVALENCE OF BORRELIA-BURGDORFERI SERUM ANTIBODIES IN 651 PATIENTS SUFFERING PREDOMINANTLY FROM NEUROLOGICAL COMPLAINTS

An analysis was undertaken to the records of 651 patients (median age 51 years, range 1-91; 334 male and 317 female patients), who were admi tted for various reasons to the department of neurology and psychosoma tics of the county hospital in Villach (Karnten, Austria), over the pe riod of one year. The clinical diagnoses were mostly neurological and psychiatric (n = 599), involving 25 different conditions. Other diagno ses (n = 52) comprised a group of 13 various conditions. Sera of all t hese patients were tested for antibodies to Borrelia burgdorferi. Over all seropositivity was 37.8%. Seropositivity increased significantly w ith age (p < 0.01). Seroprevalence exceeded 40% in patients with menin gitis, paresis of the cranial nerves, cervical syndrome, pareses and s ponylitis. The erythrocyte sedimentation rate (ESR) was raised in 37.9 % of cases which was not related to seropositivity. ESR was significan tly increased in patients with lumbago (p < 0.01) and with arthritis ( p < 0.05). Antibiotics and dosages used were recorded in 164 cases. Al l these cases improved after therapy. Of 81 patients with a history of tick bite, 43 (53%) were seropositive. This is a significantly higher incidence than that of patients without tick bites (p < 0.01). The re trospective evaluation of patients' records showed that anamnestic and clinical findings alone do not suffice to establish the specific diag nosis of Lyme borreliosis and, hence, do not provide the indication of appropriate therapy. Furthermore, the mere demonstration of serum ant ibodies to Borrelia burgdorferi does not give information on the curre nt state of infection. In case of a suspected Borrelia burgdorferi inf ection confirmatory tests are needed. Borrelia affections of the centr al nervous system and/or the nerve roots require the demonstration of intrathecally produced specific antibodies.