Test Catalog

Test ID: LNBAB    
Lyme Central Nervous System Infection IgG with Antibody Index Reflex, Serum and Spinal Fluid

Useful For Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of neuroinvasive Lyme disease or neuroborreliosis due to Borrelia species associated with Lyme disease (eg, Borrelia burgdorferi, Borrelia garinii, Borrelia afzelli)


This test should be ordered in patients with suspected neuroinvasive Lyme disease.


Although a small percentage of patients with neuroinvasive Lyme disease may be seronegative, it is recommended that all patients test by the Lyme Antibody Index assay also have standard 2-tiered testing for Lyme disease performed on serum.


This test compares the level of IgG antibodies to Lyme disease-causing Borrelia species in spinal fluid (CSF) and serum. The level of anti-Borrelia species IgG is normalized to total IgG and albumin in CSF and serum.


This test can help identify whether the presence of IgG to Borrelia species in the CSF is due to true intrathecal antibody synthesis, suggesting neuroinvasive Lyme disease, versus antibody presence due to passive diffusion through the blood-brain barrier or possibly, due to blood contamination of the CSF as a result of a traumatic lumbar puncture.

Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test IDReporting NameAvailable SeparatelyAlways Performed
LNBACLyme CNS Infection IgG Screen, CSFNoYes
LNBASLyme CNS Infection IgG, SNoNo

Reflex Tests Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test IDReporting NameAvailable SeparatelyAlways Performed
LNBAILyme CNS Infection IgG, Ab IndexNoNo

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

This test begins with IgG screening of the spinal fluid (CSF) specimen. If the screen is negative, no additional testing will be performed.


If the screen is positive, the paired CSF and serum specimens will be used to establish the antibody index. In order to establish the antibody index, the paired serum and CSF samples (collected within 24 hours of each other) are tested on the same run using quantitative assays to determine levels for the following analytes:

1. Anti-Borrelia species IgG levels in CSF and serum

2. Total IgG in CSF and serum

3. Albumin in CSF and serum


These additional tests are necessary in order to normalize the level of anti-Borrelia antibodies to total IgG and albumin in the CSF and establish the antibody index ratio of anti-Borrelia antibodies in CSF-to-serum. This testing is performed at an additional charge.


The following algorithms are available in Special Instructions:

-Lyme Neuroborreliosis Diagnostic Algorithm

-Acute Tick-Bourne Disease Testing Algorithm

-Meningitis/Encephalitis Panel Algorithm

Special Instructions Library of PDFs including pertinent information and forms related to the test

Method Name A short description of the method used to perform the test

Enzyme-Linked Immunosorbent Assay (ELISA)

NY State Available Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name Lists a shorter or abbreviated version of the Published Name for a test

Lyme CNS Infection IgG w/ AI Reflex

Aliases Lists additional common names for a test, as an aid in searching

Neuroinvasive Lyme Disease
Lyme Disease in the Central Nervous System
Lyme CNS Disease