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  1. John H. J. Wokke*,
  2. Jan A. L. Vanneste
  1. *Department of Neurology, University Medical Centre, Utrecht, the Netherlands and
  2. Department of Neurology, Sint Lucas Andreas Ziekenhuis, Amsterdam, the Netherlands; E-mail: j.wokke{at}



Neuroborreliosis is part of the spectrum of Lyme disease which was first described about a quarter of a century ago, although it existed long before that. For example, in 1909 the Swedish dermatologist Afzelius incriminated ticks as the potential vectors of an agent causing erythema migrans (Burgdorfer 1986) and DNA of the causative agent Borrelia burgdorferi has been demonstrated in archival tick specimens collected in New England in the 1940s (Persing et al. 1990).

In 1922 Garin and Bujadoux described a French peasant with erythema migrans on the left buttock (Garin & Bujaudoux 1922). He had shooting pains in his legs, trunk and one arm, and developed increasing weakness and atrophy of the right deltoid muscle. The cerebrospinal fluid (CSF) protein was raised, and there was a pleocytosis. The authors labelled the disease ‘tick paralysis’ and suggested an unknown infection transmitted by a sheep

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