Intravenous antibiotics are recommended for treating neurologic disease. One exception is isolated Bell s palsy, for which oral regimens are acceptable. Approximately 60 percent of patients with late neurologic disease have significant improvement when treated with antibiotics. An additional 20 percent of patients respond initially, then relapse. Improvement may not begin until several months after initiating therapy.
Symptoms persist in some patients despite appropriate treatment.
The explanation of such cases is controversial. Potential causes of persistent symptoms include irreversible tissue damage, ongoing autoimmune response, persistent spirochetosis, and misdiagnosis. This monograph was produced for the World Wide Web by the Northwest Center for Public Health Practice in cooperation with the Washington State Department of Health . It was adapted from the original print version. See bibliography for acknowledgements.