https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566400/

. 2020 Oct; 7(10): ofaa370.
Published online 2020 Aug 19. doi: 10.1093/ofid/ofaa370
PMCID: PMC7566400
PMID: 33094114

Imaging of Lyme Neuroborreliosis: A Pictorial Review

Abstract

Lyme neuroborreliosis is a common feature of Borrelia burgdorferi infection (as a neurological manifestation occurring in 10%–15% of all Lyme disease cases) and may involve any part of the nervous system, and its coverings, but usually manifests as lymphocytic meningitis, cranial neuritis, and/or radiculoneuritis. This review describes the imaging findings in Lyme neuroborreliosis: the focal point is on the manifestations of involvement visible on brain and spine imaging.

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**Comment**

Clarification: Far more than 10-15% have neurological manifestations.  They also show “typical” EM rashes when many rashes are atypical:  https://madisonarealymesupportgroup.com/2020/07/18/misdiagnosis-of-lyme-caused-rash-can-have-potentially-fatal-consequences/

https://madisonarealymesupportgroup.com/2016/11/02/lyme-disease-a-bioethical-morass/

https://madisonarealymesupportgroup.com/2019/02/21/lyme-disease-dont-wait-for-blood-tests-where-patients-have-bullseye-rash/

The findings report the appearance of nonspecific lesions with inflammation as well as lymphocytic pleocytosis in cerebrospinal fluid (CSF).

Key quote:

It is possible that LNB may also mimic atypical dementia and normal pressure hydrocephalus.