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Steroid use in Lyme disease ‐associated facial palsy is associated with worse long‐term outcomes

ConclusionAn association between corticosteroid use in acute LDFP and worse long‐term facial function outcomes has been demonstrated. Care should be taken in differentiating viral or idiopathic facial palsy (e.g., Bell palsy) from LDFP. Level of Evidence4. Laryngoscope, 2016
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: General Otolaryngology Source Type: research

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​BY ANUMEHA SINGH, MD, &ANDREJ KIELTYKA, PASymptomatic bradycardia is usually reserved for the over-the-hill crowd, but it is not entirely unheard of in the young and healthy. A 21-year-old African American man was sent to the emergency department by his primary care provider. The patient had no previous medical issues, normal vital signs, and was fine until about a week prior. He had quickly worsening shortness of breath while climbing the stairs to get to his dorm bedroom. The young man denied having been out in the woods or noting tick bites. He had no family history of cardiomyopathy or early cardiac events.​Th...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
The facial paralysis and drooping is caused by nerve inflammation, but the cause of that inflammation “ is a question for the ages ” says one expert.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Immune System Bell's Palsy Herpes Viruses Steroids Lyme Disease Nerves and Nervous System Source Type: news
This report highlights the continuing public health challenge of Lyme disease in states with high incidence and demonstrates its emergence in neighboring states that previously experienced few cases. Educational efforts should be directed accordingly to facilitate prevention, early diagnosis, and appropriate treatment. As Lyme disease emerges in neighboring states, clinical suspicion of Lyme disease in a patient should be based on local experience rather than incidence cutoffs used for surveillance purposes. A diagnosis of Lyme disease should be considered in patients with compatible clinical signs and a history of potenti...
Source: MMWR Surveill Summ - Category: Epidemiology Authors: Tags: MMWR Surveill Summ Source Type: research
is the most common tick-borne illness in the USA and Europe. Pathogens involved are Borrelia burgdorferi in the USA and B. afzelii and B. garinii in Europe. The characteristic rash of erythema migrans occurs in approximately 75% of patients. Neurological disease, including facial palsy, meningoencephalitis, aseptic meningitis and polyradiculopathy, occurs in 10 –15%. Cardiac disease, primarily manifest as heart block, is seen in 1–2%. Arthritis is seen as a late complication in about 30%.
Source: Medicine - Category: Internal Medicine Authors: Tags: Bacterial infections Source Type: research
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Case Report Source Type: research
Conclusions:An emerging condition, acute opthalmoparesis without ataxia and/or areflexia, was described in a handful of publications as "atypical MFS.4" The diagnostic criteria include acute onset of opthalmoplegia, presence of anti GQ1B IgG, and exclusion of other causes3. Other neurological symptoms such as blepharoptosis, bilateral facial paresis, and oropharyngeal palsy have been demonstrated with this condition.4 IVIG and plasmapharesis are not yet a well established treatment5. The diagnosis of acute opthalmoparesis without ataxia and/or areflexia underscores the vast clinical presentations associated with ...
Source: Neurology - Category: Neurology Authors: Tags: General Neurology: Inflammation, Infections, and Autoimmunity Source Type: research
Conclusions:Diagnostic approach to bilateral FNP should evaluate for: traumatic (skull fractures), infectious (classically Lyme disease), metabolic (diabetes), autoimmune (sarcoidosis, Guillain-Barré syndrome), congenital (Moebius syndrome) and neoplastic (brainstem tumors) entities. WM is a rare cause, a condition due to low-grade B cell lymphoma where lymphoplasmacytoid cells infiltrate different tissues and secrete monoclonal IgM. Peripheral neuropathy develops in 15–30% of the cases, usually a chronic, progressive, symmetric, predominantly distal polyneuropathy. Facial nerve impairment is unusual, caused b...
Source: Neurology - Category: Neurology Authors: Tags: Neuro-oncology: Brain and CNS Metastases Source Type: research
Conclusions:This case series illustrates important features currently attributed to neurosyphilis, which remains an important disease in Neurology, especially in some epidemiological risk groups.Disclosure: Dr. Borges has nothing to disclose. Dr. Germiniani has nothing to disclose. Dr. Koslyk has nothing to disclose. Dr. Teive has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
Conclusions:With this review we intend to demonstrate the wide range of neurological symptoms that LN can cause, and enhance that epidemiological context and clinical suspicion are important factors to the diagnosis.Disclosure: Dr. Espírito Santo has nothing to disclose. Dr. Almendra has nothing to disclose. Dr. Mendes has nothing to disclose. Dr. Veiga has nothing to disclose. Dr. Costa has nothing to disclose. Dr. Velon has nothing to disclose. Dr. Guimarães has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Autoimmunity with Infection, Syphilis, Lyme, Tuberculosis, and other Bacteria Source Type: research
We describe a case of bilateral simultaneous facial nerve palsy associated with Epstein-Barr virus (EBV) infection in a 3-year-old boy. Several symptoms led to the diagnosis of EBV infection: the clinical situation (fever, stomachache, and throat infection), white blood cell count (5300/mm(3) with 70% lymphocyte count), seroconversion with EBV-specific antibodies, lymphocytic meningitis, and a positive blood EBV polymerase chain reaction (9.3×10(3) copies of EBV-DNA). An MRI brain scan showed bilateral gadolinium enhancement of the facial nerve. A treatment plan with IV antibiotics (ceftriaxone) and corticosteroids w...
Source: Archives de Pediatrie - Category: Pediatrics Authors: Tags: Arch Pediatr Source Type: research
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