ABSTRACT
Antibiotic therapy is recommended for all forms of neuroborreliosis. Although stage
2 neuroborreliosis will usually resolve without any treatment, antibiotic therapy
has been associated with faster resolution of symptoms and may prevent additional
non-neurologic disease manifestations. Ceftriaxone is the most convenient parenteral
agent for stage 2 and 3 neuroborreliosis because of its once-daily dosage. Available
data indicate that a 2-4-week treatment course is adequate for most patients. Patients
with isolated seventh nerve palsy may be treated with an oral agent (for example,
doxycycline).
Recombinant outer surface protein A of Borrelia burgdorferi is a highly protective immunogen for prevention of Lyme disease in experimental animals.
Humoral immunity is sufficient for protection. A recombinant OspA vaccine has been
licensed for prevention of Lyme disease in dogs. Licensure of an OspA vaccine for
humans will depend on a critical analysis of the results of recently completed efficacy
studies.
Keywords
Vaccine - neuroborreliosis - antibiotic - antimicrobial - blood brain barrier - Lyme
disease
