A prospective study of 57 hospitalized patients with active neuroborreliosis (NB) and proved CSF antibodies was conducted using PCR for the detection of specific DNA in plasma, CSF and urine, at Faculty Hospital Bulovka; Charles University, Prague; and Hospital Nymburk, Czech Republic. Bannwarth’s syndrome (lymphocytic meningoradiculitis) was present in 29 patients, acute meningoencephalitis in 5, subacute encephalitis in 3, meningitis in 6, polyneuritis in 9, and facial palsy in 5. Neurological abnormalities were mild in 25 (44%), moderate in 17 (30%), and severe in 15 (26%). Symptoms improved with antibiotic treatment in 84%, and the remainder improved after 3 months, with no relapses.
Before treatment, 36 (63.1%) patients tested PCR positive in all parallel specimens, 28 (49.1%) were positive in urine, 20 (35%) in CSF, and 16 (28%) in plasma. Immediately after treatment, 17 (30%) were positive in urine, 8 (14%) after 3 months, and 1 persisted positive after 6 months. The highest sensitivity of PCR was found in urine, and the lowest in plasma. The results support the use of PCR in the diagnosis of NB. 
COMMENT. PCR testing for spirochetal DNA in urine or CSF, using appropriate primers, is a useful diagnostic tool in patients suspected of neuroborreliosis (NB).
Assessment of serum antibodies to a panel of Borrelia-specific antigens is of value in the laboratory diagnosis of NB at presentation of symptoms . In addition to CSF lymphocytic pleocytosis and CSF antiflagella antibodies, all 7 patients with definite NB and 7 of 13 with probable NB had serum IgG antibodies to 2 of 3 novel antigens at presentation.