Neurologic Abnormalities of Lyme Disease: Successful Treatment with High-Dose Intravenous Penicillin

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Abstract
Patients (12) were treated with high-dose i.v. penicillin for neurologic abnormalities of Lyme disease. Headache, stiff neck and radicular pain usually began to subside by the 2nd day of therapy and were often gone by 7-10 days. Of the 12 patients, 5 continued to have intermittent mild headache for several more weeks, but no patient relapsed after therapy was stopped. Compared to 15 previous patients treated with prednisone alone, the duration of meningitic symptoms was significantly shorter in those given penicillin (mean duration, 1 vs. 29 weeks, P < 0.000001). In both groups, a mean of 7-8 wk was required for complete recovery of motor deficits. Despite antibiotic therapy, 3 of the 12 patients treated with penicillin continued to have frequent arthralgias, musculoskeletal pain and fatigue. Evidently, high-dose i.v. penicillin is effective therapy for neurologic abnormalities of Lyme disease.

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