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Diagnostic tools have been significantly refined\u2014including improved peripheral blood and CSF serodiagnostics\u2014and much has been learned about the interactions between the causative pathogen and the nervous system. Despite these advances in our understanding of this disease, a broad range of other disorders continue to be misattributed to nervous system Lyme borreliosis, supported by, at best, limited evidence. These misattributions often reflect limited understanding not only of Lyme neuroborreliosis but also of what constitutes nervous system disease generally. Fortunately, a large body of evidence now exists to clarify many of these issues, establishing a clear basis for diagnosing nervous system involvement in this infection and, based on well performed studies, clarifying which clinical disorders are associated with Lyme neuroborreliosis, which with non-neurologic Lyme borreliosis, and which with neither.<\/jats:p>","DOI":"10.1093\/brain\/awac206","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T13:19:53Z","timestamp":1658150393000},"page":"2635-2647","source":"Crossref","is-referenced-by-count":34,"title":["Lyme neuroborreliosis: known knowns, known unknowns"],"prefix":"10.1093","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1170-1710","authenticated-orcid":false,"given":"John J","family":"Halperin","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Overlook Medical Center , 99 Beauvoir Ave., Summit, NJ 07901 , USA"},{"name":"Department of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA 19107 , USA"},{"name":"Department of Neurology, Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA 19107 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randi","family":"Eikeland","sequence":"additional","affiliation":[{"name":"National Advisory on Tick-borne Diseases, S\u00f8rlandet Hospital Trust , Egvsveien 100, 4615 Kristiansand , Norway"},{"name":"Faculty of Health and Sport Sciences, University of Agder , 4879 Grimstad , Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Branda","sequence":"additional","affiliation":[{"name":"Department of Pathology, Massachusetts General Hospital , Boston, MA 02114 , USA"},{"name":"Department of Pathology, Harvard Medical School , Boston, MA 02114 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Dersch","sequence":"additional","affiliation":[{"name":"Clinic of Neurology and Neurophysiology, Medical Center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg , 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,15]]},"reference":[{"key":"2022082719572974800_awac206-B1","first-page":"765","article-title":"Paralysie par les tiques","volume":"71","author":"Garin","year":"1922","journal-title":"J Med Lyon"},{"key":"2022082719572974800_awac206-B2","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/BF02095652","article-title":"Chronische lymphocytare meningitis, entzundliche polyneuritis und \u201crheumatismus\u201d","volume":"113","author":"Bannwarth","year":"1941","journal-title":"Arch Psychiatr 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