Excerpt:

Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of
23 patients submitted to strict criteria for case selection of the Centers
for Disease Control and Prevention employing a two-tier test to detect
antibodies to Borrelia burgdorferi at a single institution. One patient had
symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of
early infection; and another had symptomatic small fiber sensory neuropathy,
distal polyneuropathy, dysautonomia, and serological evidence of late
infection. In the remaining patients symptoms initially ascribed to Lyme
disease were probably unrelated to B. burgdorferi infection. Our findings
suggest early susceptibility and protracted involvement of the nervous
system most likely due to the immunological effects of B. burgdorferi
infection, although the exact mechanisms remain uncertain.