Borrelia Antibody (CSF)
Does this test have other names?
Lyme disease test (CSF)
What is this test?
This test looks for Borrelia antibodies in your cerebrospinal fluid (CSF). CSF is
the liquid that surrounds the brain and spinal cord. Borrelia burgdorferi bacteria
cause Lyme disease.
These types of bacteria, called spirochetes, are spread to humans through the bite
of an infected tick.
Lyme disease is the most common tick-borne illness in the U.S. If not treated, Lyme
disease can cause an infection of the tissues covering the brain and spinal cord (meningitis).
It can also cause:
Liver and heart problems
Inability to control facial muscles (facial palsy)
Problems that may show up months or years later, such as ongoing pain and tiredness,
arthritis, and problems with memory and concentration
This test measures the level of antibodies to the Borrelia bacteria in your CSF to
see if Lyme disease has spread to your central nervous system.
Why do I need this test?
You may need this test to find out if Lyme disease has affected your central nervous
system. Early signs that Lyme disease has affected the nervous system include:
Meningitis, an infection of the brain's protective membranes
Muscle and joint aches
Nerve inflammation that causes pain
Numbness or trouble controlling muscles in some part of your body
It's important to treat Lyme disease early. This is because it can cause:
Antibiotics can be used to treat all stages of the disease.
You may also have this test to check for other tick-borne illnesses.
What other tests might I have along with this test?
You may also have these tests:
Blood test to check for Borrelia antibodies
Other CSF tests, including cell count and protein and glucose levels
CSF gram stain and bacterial cultures to look for other disease-causing germs
Nerve conduction studies to look for damage to the peripheral nervous system
CXCL13 biomarker test of your CSF
Electrophysiology testing of peripheral nerve function
What do my test results mean?
Test results may vary depending on your age, gender, health history, the method used
for the test, and other things. Your test results may not mean you have a problem.
Ask your healthcare provider what your test results mean for you.
Some Borrelia antibodies in the blood are also likely to be found in your CSF. This
means that finding them in your CSF may not mean you have central nervous system Lyme
disease. A higher level of antibodies to Lyme disease in your CSF than in your blood
means that the antibodies may be multiplying there. This may mean that the disease
has spread to your central nervous system.
You will likely be diagnosed with central nervous system Lyme disease if your test
results show most or all of these conditions:
You have higher counts of lymphocytes, monocytes, or both in your CSF. These are both
types of white blood cells that may mean you have an acute infection.
Your CSF protein concentration is 200 to 300 milligrams per deciliter (mg/dL).
You have a higher level of Borrelia antibodies in your CSF than in your blood after
adjusting your blood and CSF antibody tests so that both have an equal concentration
of IgG antibodies.
A negative result means that no Borrelia antibodies were found. But a negative result
of this test alone doesn't rule out the possibility of nervous system Lyme disease.
A diagnosis is usually made after looking at the results of several types of tests.
How is this test done?
This test requires a sample of CSF. A sample is taken through a lumbar puncture in
your lower back. During this procedure, you either sit up and lean forward, or lie
down on your side. A healthcare provider injects a numbing medicine in the skin of
your back. Then the provider inserts a needle into your spine and draws out a sample
Does this test pose any risks?
Nerve pain or numbness
Talk with your provider about the risks before the test. Be sure to tell your provider
if you've had a seizure, increased pressure in your eyes, or other health problems.
What might affect my test results?
Other factors aren't likely to affect your results.
How do I get ready for this test?
You don't need to prepare for this test. But be sure your healthcare provider knows
about all the medicines, herbs, vitamins, and supplements you are taking. This includes
medicines that don't need a prescription and any illegal drugs you may use.