{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:43:43Z","timestamp":1792827823311,"version":"4.5.0"},"reference-count":34,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2018,8,20]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p>\n                    Lyme disease (borreliosis) is a tick-borne bacterial infection caused by the spirochaete\n                    <jats:italic>Borrelia burgdoferi<\/jats:italic>\n                    , transmitted by hard-backed\n                    <jats:italic>Ixodes<\/jats:italic>\n                    ticks. Actual numbers of cases are increasing and it appears that the distribution across the UK is widening; however, it occurs most frequently in area of woodland, with temperate climate. It typically presents in mid to late summer. Lyme disease is a multisystem disease. The nervous system is the second most commonly affected system after the skin. Other systemic manifestations, such as carditis, keratitis, uveitis and inflammatory arthritis, rarely occur in European Lyme disease. In 2018, the National Institute for Health and Care Excellence has updated its guidelines on the diagnosis and management of Lyme disease. Here, we highlight important aspects of this guidance and provide a more detailed review of the clinical spectrum of neuroborreliosis, illustrated by cases we have seen.\n                  <\/jats:p>","DOI":"10.1136\/practneurol-2018-001998","type":"journal-article","created":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T12:37:52Z","timestamp":1538570272000},"page":"455-464","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["Lyme disease: diagnosis and management"],"prefix":"10.1136","volume":"18","author":[{"given":"Amy L","family":"Ross Russell","sequence":"first","affiliation":[{"name":"Neurology Department, Wessex Neurosciences Centre, Southampton General Hospital, Tremona Road, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S","family":"Dryden","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infection, Hampshire Hospitals NHS Foundation Trust & Rare and Imported Pathogens Department, PHE, Porton, Salisbury, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin A","family":"Pinto","sequence":"additional","affiliation":[{"name":"Neurology Department, Wessex Neurosciences Centre, Southampton General Hospital, Tremona Road, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna K","family":"Lovett","sequence":"additional","affiliation":[{"name":"Neurology Department, Wessex Neurosciences Centre, Southampton General Hospital, Tremona Road, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"2025090409591022000_18.6.455.1","unstructured":"Public Health England . 2017.Quarterly zoonosis reports. https:\/\/www.gov.uk\/government\/publications\/common-animal-associated-infections-quarterly-reports-2017"},{"key":"2025090409591022000_18.6.455.2","unstructured":"NICE , 2018. Lyme disease overview. https:\/\/pathways.nice.org.uk\/pathways\/lyme-disease"},{"key":"2025090409591022000_18.6.455.3","unstructured":"Public Health England . 2013.Lyme borreliosis epidemiology and surveillance. https:\/\/www.gov.uk\/government\/publications\/lyme-borreliosis-epidemiology\/lyme-borreliosis-epidemiology-and-surveillance"},{"key":"2025090409591022000_18.6.455.4","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1017\/S0950268814001071","article-title":"Lyme borreliosis in southern United Kingdom and a case for a new syndrome, chronic arthropod-borne neuropathy","volume":"143","author":"Dryden","year":"2015","journal-title":"Epidemiol Infect"},{"key":"2025090409591022000_18.6.455.5","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2015.121"},{"key":"2025090409591022000_18.6.455.6","doi-asserted-by":"crossref","DOI":"10.1017\/S0950268808000472","article-title":"Neuroborreliosis in the South West of England","volume":"136","author":"Lovett","year":"2008","journal-title":"Epidemiol Infect"},{"key":"2025090409591022000_18.6.455.7","doi-asserted-by":"publisher","DOI":"10.3201\/eid0604.000416"},{"key":"2025090409591022000_18.6.455.8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/00365548.2014.961544","article-title":"Vasculitis and stroke due to Lyme neuroborreliosis\u2014a review","volume":"47","author":"Zajkowska","year":"2015","journal-title":"Infect Dis"},{"key":"2025090409591022000_18.6.455.9","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/S0140-6736(89)91377-9","article-title":"Lyme disease: prevalence and clinical importance of Borrelia burgdorferi specific IgG in forestry workers","volume":"1","author":"Guy","year":"1989","journal-title":"Lancet"},{"key":"2025090409591022000_18.6.455.10","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3201\/eid2101.140009","article-title":"Antibodies against Borrelia burgdorferi sensu lato among Adults, Germany, 2008\u20132011","volume":"21","author":"Wilking","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"2025090409591022000_18.6.455.11","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0934-8840(98)80142-4","article-title":"Risk of infection with Borrelia burgdorferi sense lato for a host in relation to the duration of nymphal Ixodes ricinus feeding and the method of tick removal","volume":"287","author":"Kahl","year":"1998","journal-title":"Zentralblatt f\u00fcr Bakteriologie"},{"key":"2025090409591022000_18.6.455.12","doi-asserted-by":"crossref","unstructured":"Hansen K , Crone C , Kristoferitsch W . Lyme neuroborreliosis. In: Said G , Krarup C , eds. Handbook of clinical neurology. 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Lyme disease life cycle. www.cdc.gov"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/practneurol-2018-001998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T16:59:23Z","timestamp":1757005163000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/practneurol-2018-001998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,3]]},"references-count":34,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,11,16]]},"published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1136\/practneurol-2018-001998"],"URL":"https:\/\/doi.org\/10.1136\/practneurol-2018-001998","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,3]]}}}