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

Table 1 Frequency of meningitis in facial palsy Meningitis Etiology no yes sum non-Lyme 46 25 (35.2%) 71 Lyme 25 36 (59.0%) 61 Sum 71 61 132 p< 0.005 Neuroborreliosis Bannwarths syndrome (BS). Twenty-four typical cases of BS were diagnosed. The low number of patients in this group may be due to the strict diagnostic criteria. Only clinically unambiguous cases with CSF pleocytosis were enrolled. Usually the neurological examination found only mild organic signs, and nuchal rigidity was missing. In many cases, lumbar puncture was made only after receiving the positive serum antibody finding or after the more severe general symptoms or headache had developed (74). Fever was observed in about half of the paediatric patients but in a lower percentage in adulthood. Myelography was done in half of the patients and CT in almost all of them. CNS tumour or discopathy was the suspected diagnosis in almost every case. The clinical symptoms resembled multiple sclerosis in four patients. Pleocytosis was mild (average: 267) in most cases of Lyme meningitis (Fig. 2), but in three cases more than 1000 cells/mm

3 were observed. CSF cytology revealed 25-35 per cent granulocyte in two cases of Lyme meningitis. In nine of the 14 CSF samples where plasmocytes were looked for, at least 5 per cent were noted. The protein level was elevated in almost every Lyme meningitis case (average 1.17 g/1, SD:0.91) and in half of them it was extremely high (Fig. 3). The very high CSF proTable 2 Frequency of bilateral facial palsy in Lyme borreliosis Facial palsy Etiology unilateral bilateral sum non-Lyme 470 18* (3.7%)* 488 Lyme 149 17(10.2%) 166 Sum 619 35 654 p< 0.005 * 6/18 Guillain-Barré syndrome