Tickpedia
Removal · field guidance

Diagnostic algorithm for late neurologic Lyme

Late neuroborreliosis requires positive serum IgG plus objective neurologic findings; intrathecal antibody testing is supportive but not required in the US.

Steps

schema.org/HowTo
  1. 01
    Confirm objective neurologic findings (radiculopathy, encephalopathy, peripheral neuropathy).
  2. 02
    Order serum two-tier Lyme serology — IgG should be strongly positive in late disease.
  3. 03
    Consider lumbar puncture if CNS involvement is suspected; look for lymphocytic pleocytosis.
  4. 04
    Calculate CSF/serum antibody index for Borrelia (intrathecal production) — supportive when positive.
  5. 05
    Negative serum IgG essentially rules out late neurologic Lyme; pursue alternative diagnoses.

Wild facts

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