Immunologic Reactivity Against Borrelia Burgdorferi in Patients With Motor Neuron Disease

John J. Halperin, Gary P. Kaplan, Shari Brazinsky, T. F. Tsai, Teresa Cheng, Audrey Ironside, P. Priscilla, Joel Delfiner, Marc Golightly, Robert H. Brown, Raymond J. Dattwyler, Benjamin J. Luft

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67 Scopus citations

Abstract

Of 19 unselected patients with the diagnosis of amyotrophic lateral sclerosis (ALS) living in Suffolk County, New York (an area of high Lyme disease prevalence), 9 had serologic evidence of exposure to Borrelia burgdorferi; 4 of 38 matched controls were seropositive. Eight of 9 sero-positive patients were male (8 of 12 male patients vs 2 of 24 controls). Rates of seropositivity were lower among patients with ALS from nonendemic areas. All patients had typical ALS; none had typical Lyme disease. Cerebrospinal fluid was examined in 24 ALS patients—3 (all with severe bulbar involvement) appeared to have intrathecal synthesis of anti-B burgdorferi antibody. Following therapy with antibiotics, 3 patients with predominantly lower motor neuron abnormalities appeared to improve, 3 with severe bulbar dysfunction deteriorated rapidly, and all others appeared unaffected. There appears to be a statistically significant association between ALS and immunoreactivity to B burgdorferi, at least among men living in hyperendemic areas.

Original languageEnglish
Pages (from-to)586-594
Number of pages9
JournalArchives of Neurology
Volume47
Issue number5
DOIs
StatePublished - May 1990
Externally publishedYes

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