rom :  The American Journal of Medicine
  Volume 98 (suppl 4A)  April 24, 1995
pg.  4A-38S

John J. Halperin:  ".......To draw an analogy
 to syphilis, we know from the
infamous Tuskegee study that two thirds
of those who develope early mmeningitis
will never go on to develope late neurologic
 disease.  There are a lot of
reassuring data, although  
WE DON"T THE ANSWER.    
A.R. Pachner:  ".....I know some people will
 fail doxycycline therapy no matter
what some of the data show..."....The
 organism does enter the CNS fairly
soon....the organism likes the basilar areas,
 and sometimes it takes a while
for the inflammation and the organism to
reach there...."
Question:   "I was involved in a the study
comparing 2 versus 4 weeks of
intravenous ceftriaxone for treatment of late
 Lyme disease.  Most of the
patients that I saw in Westchester County
 (New York) had well-documented Lyme
arthritis, with typical presentation and
confirmatory serology.  One of the
observations I made is that almost none
of these patients had any CNS
complaints.  In light of your animal data,
can you comment on that?"
Pachner:  "I don't know why more patients
 with Lyme arthritis  don't have
neurologic symptoms.  The organism goes
 into the CNS early.  Many of the
troubling symptomatic signs can be
attributed to early inflammation in the
nervous system.  The headache, the stiff neck,
and the malaise are often due to
this intial inflammation.  As my study in the
 monkey shows, frequently this
inflammation can subside, but the organism
 does not go away.  There are
patients who have Lyme arthritis  who will
 end up having organism in their
brain.  And we still don't know whether that
  is live organism or dead organism
because PCR does not allow you to
 differentiate.  But, I suspect that if I
examined the brains of those patients,
a large percentage of them would have
Borrelia burgdorferi.  Why do I think that?
 Out of three spinal taps from
people who had no CNS symptoms whatever,
one was clearly PCR positive.  It is
not a huge number, but my access to
 brain biopsies is limited."
Question:  "So the conclusion is, then,
that frequently the neurologic disease
is silent?"
Pachner:   "Yes, silent."

August 5, 1993
The Lyme Disease {*filter*}          
by Joseph J. Burrascano, Jr., M.D.
Reprinted from Senate Committee Hearing on
 Lyme Disease
Original found at: http://www.jersey.net/~joebur/news.htm

"3. After short courses of treatment, patients with
advanced disease rarely
return to normal, yet many can be proven to still be
 infected and can often
respond to further antibiotic therapy. Unfortunately,
 Lyme patients are being
denied such therapy for political reasons and/or
 because insurance companies
refuse to pay for longer treatment, upon the arbitrary
 and uninformed advice of
these physicians, who are on the insurance company's
 payroll.

4. Long term studies on patients who were untreated
or undertreated
demonstrated the occurrence of severe illness more than
a decade later,
reminiscent of the findings of the notorious Tuskeege
 Study, in which
intentionally untreated syphilis patients were allowed
 to suffer permanent and
in some cases fatal sequelae.

5. The Lyme bacterium spreads to areas of the
 body that render this organism
resistant to being killed by the immune system and
by antibiotics, such as in
the eye, deep within tendons, and within cells.
The Lyme bacterium also has a
very complex life cycle that renders it resistant to
simple treatment
strategies. Therefore, to be effective, antibiotics
 must be given in generous
doses over several months, until signs of active
 infection have cleared.
Because relapses have appeared long after seemingly
 adequate therapy, long term
followup, measured in years or decades, is required
                     before any treatment
regimen is deemed adequate or curative. ..."

Chronic Neurologic Manifestations of Lyme Disease
Loggian, Kaplan, Steere
,,,,,,,Discussion.....These chronic neurologic abnormalities began months
to years after the onset of infection, sometimes after long periods of
latency, as in neurosyphilis....The typical response of our patients to
antibiotic therapy supports the role of spirochetal infection in the
pathogenisis of each of the syndromes described here......The likely reason
for relapse is failure to eradicate the spirochete.......This is
reminiscent of far advanced neurosyphilis.......  
.

from Borrelia burgdorferi (Lyme Disease, Lyme Borreliosis) by Allen C. Steere
Infectious Diseases and Their Etiologic Agents
Chapter 219

"    Lyme disease,......After months to years , sometimes following long
 periods of latent infection, the spirochete may cause persistent disease, most
 commonly affecting the joints, nervoius system, or skin...."