All Posts Tagged With: "Department of Neurology"

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20666055&retmode=ref&cmd=prlinks

Excerpt:

Lyme disease is a multisystem infectious disease, endemic in
parts of Europe, including the West of Ireland. Neurological
manifestions (neuroborreliosis) are variable. Presenting
neurological syndromes include meningitis, cranial neuropathies,
myeloradiculitis and mononeuritis multiplex. A lack of
specificity in serological diagnosis may add to diagnostic
confusion. We reviewed thirty cases of acute Lyme disease in the
West of Ireland and found neurological syndromes in 15 (50%),
with painful radiculopathy (12 patients; 80%) and cranial
neuropathy (7 patients; 46%) occurring frequently.
Neuroborreliosis needs to be considered in the differential
diagnosis of these neurological syndromes in the appropriate
clinical context.

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20621802&retmode=ref&cmd=prlinks

Excerpt:

Lyme optic neuritis (ON) is a rare disease and only a few cases
have been reported. We describe two cases of isolated Lyme ON,
one with recurrence 9 months after the appearance of initial
symptoms. Diagnosis criteria for multiple sclerosis and
neuromyelitis optica were not met. The etiological diagnosis was
based on European case definition criteria for neuroborreliosis.
Both patients had positive serum and cerebrospinal fluid
serology, a positive intrathecal anti-Borrelia antibody index,
and a good outcome on ceftriaxone. Specific diagnosis of Lyme ON
is important since improvement of visual acuity is possible with
specific antibiotherapy, even after many months. Copyright (c)
2010 Elsevier B.V. All rights reserved.

Excerpt:

If you have multiple sclerosis (MS)––or you know someone who does––you probably remember how long it took to make the diagnosis.  You also may remember a lot of blood tests, a lumbar puncture, at least one magnetic resonance imaging (MRI) scan, as well as many visits and examinations by various doctors.  You may wonder why it still takes so long to make the diagnosis in this modern age of MRIs and other sophisticated tests.  We are going to try to explain why it can be so difficult for even the most expert MS neurologist to determine that someone has MS.  You have to live with the diagnosis and face the disease and the treatments.  You should understand and have confidence in the diagnosis.  Also, if your case of MS does not fit the typical pattern, you need to be aware of the other disorders that can mimic MS.  This is important because the treatments may be very different and, just as in most cases of MS, treatment begun early in the course of the disease is the best way to prevent or slow further neurologic damage.

MRI and new laboratory tests have definitely helped speed the diagnosis, but it still takes longer than anyone would wish, even in easy cases.  This is partly because of the variable nature of the disease in its many signs and symptoms. But it is also because a rather long list of other medical disorders can cause neurologic symptoms and signs that resemble MS. Furthermore, the “white spots” on brain MRI can be caused by a number of other conditions that also need to be ruled out.

The diagnosis of clinically definite MS requires that a person experience at least two neurologic symptoms of the type seen in MS, in two different areas of the central nervous system (CNS), at two different times (‘disseminated in space and time’).  Most typically, the symptoms are optic neuritis plus either an abnormal sensation or a problem with movement.  It can also be numbness in one part of the body and weakness or lack of coordination in another.  But in every case, there can be no other explanation for the symptoms, the changes seen on the MRI, and the abnormalities in the spinal fluid.  Many “mimics” need to be ruled out in order to make the diagnosis of MS.