2018 Aug;49(6):399-404. doi: 10.1016/j.arcmed.2018.11.007. Epub 2018 Dec 13.

Lyme Neuroborreliosis is a Severe and Frequent Neurological Disease in Mexico.



To describe clinical cases with neurological manifestations associated with Borrelia burgdorferi infection in a large cohort of children and adults from Mexico.


Patients with neurological manifestation (cranial neuritis, radiculoneuritis, meningitis and encephalomyelitis) were recruited in one pediatric and two general hospitals, during January 2006-December 2015. Blood and cerebrospinal fluid (CSF) samples were drawn from each patient at inclusion. IgM and IgG antibodies against B. burgdorferi were detected using a commercial ELISA test, and confirmed by Western-Blot test (WB) using three different antigens from Borrelia burgdorferi complex. Following CDC criteria were considered true cases with both positive tests.


Of 606 patients recruited, 403 (66.5%) were adults and 203 (33.4%) children, 50.5% were male.

  • B. burgdorferi infection was diagnosed in 168 patients (27.7%), 97 adults, mean age 42 ± 14.7 years and 71 children, mean age 9.6 ± 5 years;
  • early disseminated disease occurred in 130 cases (77.4 %) and
  • chronic stage in 38 (22.6 %)
  • A previous tick bite was reported by 21% cases, and
  • 5% recalled an erythema migrans lesion
  • Polyradiculoneuropathy and encephalomyelitis were the most common manifestations, whereas
  • 14.8% presented an initial Guillain-Barré Syndrome
  • B. burgdorferi sensu stricto was identified in 142 (84%) cases,
  • B. garinii in 14 (8%),
  • B. afzelii in three, and
  • nine cases presented coinfection with two species


Lyme neuroborreliosis is a frequent condition in patients with neurological diseases in Mexico.



Although a year old, utilizing even older data, this is HUGE, and I’m sure has only gotten worse. Most don’t even consider Lyme disease in South America, much less a severe and frequent disease.

Please note that they only considered people positive IF they tested positive on the abysmal 2-tiered CDC testing that misses over half of all cases:  It’s interesting to me that they describe “clinical” cases of neurological symptoms, yet continue to utilize abysmal testing as their means of diagnosis. What a shame.

How many infected Mexican patients were missed due to poor testing?

Also, please note only 5% recalled an EM rash. This criteria also needs to be thrown to the way-side as a standard for diagnosis:  Again, if you are lucky enough to get the EM rash, YOU HAVE LYME DISEASE; however, even if you don’t have the EM rash, you might STILL HAVE LYME DISEASE.

Notice nearly 15% presented with an initial Guillain-Barre Syndrome as well as the fact 9 cases had coinfection with TWO species of borrelia.

For more on Lyme in South America:

Also, please remember Lyme (borrelia) is only one of many. Patients are typically coinfected with numerous other pathogens:  If all they used was CDC 2-tiered Lyme testing, not only did they miss tons of patients who weren’t “positive enough,” yet still infected, they also missed the fact many were probably infected with other pathogens.