By Linda on Feb 12, 2010 in Infections | comments(0)
Lyme disease (borreliosis) is a systemic illness resulting from infection
with the spirochete Borrelia burgdorferi. It is transmitted to humans by the
bites of infected ticks belonging to several species of the genus Ixodes.
After the bacteria enter the body via the dermis, most patients develop the
early, localised form of Lyme disease, which is characterised by erythema
migrans and influenza-like symptoms. This disease may also affect the heart,
nervous system and joints. The neurological findings of this disease may
include peripheral and central nervous system signs.
A 21-year-old woman attended a family medicine outpatient clinic complaining
of unexplained pain and muscle power loss in her lower extremities. The
problem had started in her right leg 3 months earlier and worsened in the
last week. She had a neurology consultation and was hospitalised. Her
neurological examination revealed bilateral facial paralysis and sensory
impairment. Immunoglobulin M antibody to B. burgdorferi was positive on
Western blotting in both serum and cerebrospinal fluid. The patient was
diagnosed with subacute neuroborreliosis and treated.
Acta Neurol Belg. 2009 Dec;109(4):326-9.
Koc F, Bozdemir H, Pekoz T, Aksu HS, Ozcan S, Kurdak H.
Department of Neurology, Cukurova University School of Medicine, Adana,
Turkey.
koc.filiz@gmail.com
By Linda on Dec 30, 2009 in General News | comments(0)
OBJECTIVE: Recent studies have suggested an important role of the B-cell chemoattractant CXCL13 in acute neuroborreliosis (NB). Our aim was to confirm the diagnostic role of CXCL13 and to evaluate its relevance as a therapy response and disease activity marker in NB. Continued
By Bryan Rosner on Nov 29, 2009 in Infections | comments(0)
Clinical practice guidelines are increasing in number. Unfortunately,
when scientific evidence is uncertain, limited, or evolving, as is often
the case, conflict often arises between guideline committees and
practicing physicians, who bear the direct responsibility for the care of
individual patients. The 2006 Infectious Diseases Society of America
guidelines for Lyme disease, which have limited scientific support,
could, if implemented, limit the clinical discretion of treating physicians
and the treatment options available to patients
Introduction
Clinical practice guidelines are now ubiquitous throughout the
United States. The National Guidelines Clearing House, under the
category “diseases,” currently lists 2,126 separate guidelines on its
web site. Clinical guidelines are intended to assist physicians in
patient care by clearly communicating the results of the guideline
committees’ evaluation of available therapeutic options. However,
the processes by which individual guidelines are constructed may be
less clear, leading to disagreements between the issuing committee
and the physicians who treat patients-physicians who may well be
as experienced and knowledgeable as the guideline committee. Continued
By Linda on Nov 29, 2009 in Infections | comments(0)
Encephalopathy is like fine art: Most people know it when they see it, but there is very little agreement on how to define it. At the 14th International Lyme Disease Conference, Brian A. Fallon, MD,[1] of Columbia University and the New York State Psychiatric Institute, New York, NY, tried to do just that. More importantly, he described the different ways one can define encephalopathy, the strengths and limitations of each approach, and significantly, what other aspects of life can give the impression of encephalopathy where none exists. First, one must evaluate patients with persistent Lyme encephalopathy by asking the following questions:
Is the diagnosis correct?
Are there comorbid psychiatric disorders that could be treated better? Does the patient have a psychogenic medical illness? What was the patient’s response to prior antibiotics?
Was previous treatment adequate? How long was the course, and what was the route of administration? Was there a subsequent relapse Continued
By Linda on Nov 29, 2009 in Infections | comments(0)
Encephalopathy is like fine art: Most people know it when they see it, but there is very little agreement on how to define it. At the 14th International Lyme Disease Conference, Brian A. Fallon, MD,[1] of Columbia University and the New York State Psychiatric Institute, New York, NY, tried to do just that. More importantly, he described the different ways one can define encephalopathy, the strengths and limitations of each approach, and significantly, what other aspects of life can give the impression of encephalopathy where none exists.
First, one must evaluate patients with persistent Lyme encephalopathy by asking the following questions:
Is the diagnosis correct?
Are there comorbid psychiatric disorders that could be treated better? Does the patient have a psychogenic medical illness? What was the patient’s response to prior antibiotics?
Was previous treatment adequate? How long was the course, and what was the route of administration? Was there a subsequent relapse Continued
