Criteria for definite neuroborreliosis >= 4 of the following:
(1) positive anti-Borrelia antibody index (AI)
(2) absence of a past history of neuroborreliosis
(3) CSF anti-Borrelia antibodies
(4) favorable outcome following specific antibiotic therapy for neuroborreliosis
(5) absence of other conditions that can explain the findings
where:
• The testing for antiborrelia antibodies should be done using the strains seen where the disease was acquired. An infection acquired in Europe may give negative antibody titers in the US, and vice versa.
• A favorable outcome after specific antibiotic therapy implies the presence of neurologic symptoms.
• It would be hard to have a positive anti-Borrelia antibody index in the CSF without CSF anti-Borrelia antibodies being present.
• To have a favorable outcome to specific antibiotic therapy implies that a presumptive diagnosis was made.
The diagnosis of definite neuroborreliosis can also be made with both of the following (page 957):
(1) positive anti-Borrelia antibody index
(2) neurologic symptoms
