Neuroborreliosis REVIEW

ing tick bite (Garin-Bujadoux-Bannwarth, or Bannwarth’s syndrome). Because a tick-borne infection was suspected, some patients were empirically treated with penicillin and rapidly recovered. Then, in the late 1970s, a tick-borne disease was diagnosed in children in Lyme, Connecticut. The fi rst manifestation of what at fi rst was thought to be a novel disease, named Lyme disease, was erythema around the tick bite. In some patients disseminated infection evolved within days or weeks, affecting the nervous system, heart or joints (Steere 2001). The neurological features were unilateral or bilateral facial palsy, sometimes accompanied by headache as a sign of mild meningitis, and features of a motor or sensory radiculoneuropathy. The CSF showed a mild lymphocytic pleocytosis. By elegant analyses of the intestines of ticks that were recovered from skin and arthritic lesions, and antibody testing, Dr Willy Burgdorfer and colleagues showed that a Borrelia species was responsible for the infection (Burgdorfer et al. 1982). Diagnostic tests were then developed and a few years later antibodies against B. burgdorferi were demonstrated in European patients with Bannwarth’s syndrome.