Immunologic reactivity against Borrelia burgdorferi in patients with motor neuron disease

Published Date
Journal
JAMA Neurology
Citation
Arch Neurol. 1990 May;47(5):586-94
DOI
10.1001/archneur.1990.00530050110021
Authors
Halperin JJ
Kaplan GP
Brazinsky S
Tsai TF
Cheng T
Ironside A
Wu P
Delfiner J
Golightly M
Brown RH
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 seropositive patients were male (8 of 12 male patients vs 2 of 24 controls). Rates of seropositivity were lower among patientswith 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.