ABSTRACT
Lyme disease, particularly as it affects the nervous system, has been the source of tremendous confusion and concern among both patients and physicians. Physicians practicing in Lyme-endemic areas constantly find themselves torn in trying to understand how best to help patients with troubling but ill-defined syndromes, who are convinced that they have Lyme disease which they know will finally resolve if only they could get a few more months of antibiotics. This concept is supported by advertisements in the media alluding to how this infection can so easily be confused with ‘‘lifestyle symptoms,’’ by web sites promulgating information that is less than scientifically rigorous, and by misinterpretation of legitimate descriptions of areas of scientific doubt that are often extrapolated to indicate that this disease is totally incomprehensible. At the same time, the heavy emphasis on these ill-defined phenomena has led to such widespread skepticism and misperceptions that patients who present with the classic findings of neuroborreliosis (nervous system Lyme disease) often go undiagnosed for extended periods of time.
