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Chronic Neurologic Manifestations of Lyme Disease
NEJM 323:1438-1444, Logigian,E.L.,et al, 1990
See this aricle in Pubmed

Article Abstract
Of the 27 patients,24(89 percent)had a mild encephalopathy that began 1 month to 14 years after the onset of the disease and was characterized by memory loss,mood changes,or sleep disturbance.Of the 24 patients,14 had memory impairment on neuropsychological tests,and 18 had increased cerebrospinal fluid protein levels,evidence of intrathecal production of antibody to B.burgdorferi,or both.Nineteen of the 27 patients(70 percent) had polyneuropathy with radicular pain or distal paresthesias;all but two of these patients also had encephalopathy.In 16 patients electrophysiologic testing showed an axonal polyneuropathy.One patient had leukoencephalitis with asymmetric spastic diplegia,periventricular white- matter lesions,and intrathecal production of antibody to B.burgdorferi. Among the 27 patients,associated symptoms included fatigue(74 percent), headache(48 percent),arthritis(37 percent),and hearing loss(15 percent).At the time of examination,chronic neurologic abnormalities had been present from 3 months to 14 years,usually with little progression.Six months after a two-week course of intravenous ceftriaxone(2 g daily),17 patients(63 percent)had improvement,6(22 percent)had improvement but then relapsed,and 4(15 percent)had no change in their condition.Conclusions.Months to years after the initial infection with B.Burgdorferi,patients with Lyme disease may have chronic encephalopathy,polyneuropathy,or less commonly, leukoencephalitis.These chronic neurologic abnormalities usually improve with antibiotic therapy.
 
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antibiotics
arthritis
ceftriaxone
cerebrospinal fluid,abnormal
depression
encephalopathy
fatigue
fibromyalgia
headache
hearing loss
leukoencephalitis
Lyme disease
memory,impairment of
mood change
MRI
MRI,abnormal
neuropathy
pain
paresthesias
polyneuropathy
radiculitis
sleep pathology and physiology
spastic diplegia
spirochete infection
treatment of neurologic disorder
white matter disease
white matter disease,periventricular

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