Dr. Murai Éva szerk.: Parasitologia Hungarica 24. (Budapest, 1991)

In the statistical analysis some of the data were missing in most cases. That is why only a part of the patients are shown in the figures and tables. The number of cases available for actual calculations are indicated, but the missing data are not. The categories of "Lyme-case" or "non-Lyme" will frequently be used in data processing. A patient was regarded to have Lb if one of the criteria below was fulfilled: 1. If a typical picture of Lb was seen (ECM, ACA, LBC, BS) independently of the serological results. 2. If a significantly elevated specific antibody level was found in the serum and/or in the CSF. The frequently seen manifestations of Lb will be called major symptoms. These major symptoms can easily be judged on the clinical examination. 1. ACA: The diagnosis was based on the typical dermatological picture. 2. Arthritis: Joint involvement with swelling was accepted only. Bone and joint pains were classified separately. The category of arthralgia was used in the latter case. 3. Bannwarth's syndrome: Lymphocytic meningitis accompanied by radicular pain and sensory disturbances. 4. Carditis: Was accepted only when ECG changes were documented. 5. ECM: The diagnosis was based on the typical dermatological picture. The category of "complicated ECM" is used if any extradermal symptom (fever, malaise, or major symptoms: e.g. facial palsy) were detected. 6. Facial palsy: Only the peripheral type is included in this category. Many cases of this group were enrolled by screening tests. All the Bell's palsy cases which had been seen in three hospitals were screened for Bb antibody in the last two years of the study. 7. Central nervous system involvement (CNSI): Patients with CSF pleocytosis were assigned to this category. Meningitis was accompanied by mild encephalopathy in almost every case. Therefore the two overlapping syndromes (meningitis and encephalitis) were not separated. 8. LBC: The diagnosis was based on the typical dermatological picture. 9. Peripheral neuritis: Patients were enlisted in this category with complaints of paraesthesia or limb weakness even if "objective" signs of neurological involvement could not be detected. RESULTS Clinical Manifestations Dermatological involvements Erythema chronicum migrans (ECM). ECM is the most typical sign of Lb. Inflammation of the skin usually begins within a month after tick bite. It showed a