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Response Letter to Drs. Halperin and Greenberg

We thank Drs. Halperin and Greenberg for their interest in our recent article that provided a critical appraisal of what has been termed the mild axonal peripheral neuropathy of late neurologic Lyme disease [1 –3]. Dr. Halperin is correct that this entity was described in papers published over 20years ago [4–7]. Essentially, no recent articles have provided any new data affirming this entity in North America, but no systematic and rigorously conducted studies have been conducted to refute the existenc e of this entity in North America as well.
Source: Diagnostic Microbiology and Infectious Disease - Category: Microbiology Authors: Source Type: research

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Publication date: 2017 Source:Handbook of Clinical Neurology, Volume 145 Author(s): Istvan Katona, Joachim Weis This chapter reviews the diseases of the peripheral nerves from a neuropathologic point of view, with a special focus on specific morphologic changes, and includes a summary of the histopathologic methods available for their diagnosis. As the rate of obesity and the prevalence of type 2 diabetes increase, diabetic neuropathy is the most common cause of peripheral neuropathy. Many systemic disorders with metabolic origin, like amyloidosis, hepatic failure, vitamin deficiencies, uremia, lipid metabolism disorders,...
Source: Handbook of Clinical Neurology - Category: Neurology Source Type: research
Conclusions:Our case demonstrates that rapidly progressive acute axonal polyneuropathy is a serious neurological manifestation of porphyria and if not diagnosed early, can lead to irreversible axonal injury and severe disability. This diagnosis should be considered in all cases of acute ascending weakness with minimal sensory deficits when electrodiagnostic features of demyelination are lacking.Disclosure: Dr. Sharma has nothing to disclose. Dr. Kumbham has nothing to disclose. Dr. Sahaya has nothing to disclose. Dr. Sasapu has nothing to disclose. Dr. Gundogdu has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Neuromuscular and Clinial Neurophysiology (EMG): Peripheral Neuropathy II 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 establishes the importance of clinical reasoning. Neurological exam suggested multilevel radiculopathy/plexopathy. Normal SNAPS argue against plexopathy, MRI, and CSF analysis confirmed the diagnosis of secondary CNS lymphoma invading the meninges and nerve roots.Disclosure: Dr. Datta has nothing to disclose. Dr. Roy has nothing to disclose. Dr. Meira Benchaya has nothing to disclose. Dr. Boland has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: Neuromuscular and Clinical Neurophysiology (EMG): Peripheral Neuropathy III Source Type: research
It can only be hoped that the paper by Wormser et al.(Wormser&Strle, 2016) can accomplish what a quarter century of deliberate neglect has not – the elimination of the concept of a symmetric diffuse axonal neuropathy as a distinct nosologic entity in Lyme disease. As the authors point out, this concept was introduced early in our understanding of Lyme disease –before 2 tier serologic testing - and included some patients diagnosed on th e basis of T cell testing – a procedure then advocated by one of Dr.
Source: Diagnostic Microbiology and Infectious Disease - Category: Microbiology Authors: Source Type: research
I read with great interest the article by Wormser et al. but found that many of the authors' stated reasons for questioning the existence and frequency of this type of Lyme neuropathy require critical appraisal themselves.
Source: Diagnostic Microbiology and Infectious Disease - Category: Microbiology Authors: Tags: Letter to the editor Source Type: research
In older studies, a chronic distal symmetric sensory neuropathy was reported as a relatively common manifestation of late Lyme disease in the United States. However, the original papers describing this entity had notable inconsistencies and certain inexplicable findings, such as reports that this condition developed in patients despite prior antibiotic treatment known to be highly effective for other manifestations of Lyme disease. More recent literature suggests that this entity is seen rarely, if at all.
Source: Diagnostic Microbiology and Infectious Disease - Category: Microbiology Authors: Source Type: research
Conclusions: We bring to your attention a novel case series of chronic, inflammatory immunoresponsive myeloneuropathy with very unique clinical syndrome.Disclosure: Dr. Mitrabhakdi has nothing to disclose. Dr. Goodman has nothing to disclose. Dr. Laothamatas has nothing to disclose. Dr. Lewis has received personal compensation for activities with CSL Behring, Pharnext, Novartis, and Axelacare.
Source: Neurology - Category: Neurology Authors: Tags: Acquired Peripheral Neuropathies: Clinical and Pathological Aspects Source Type: research
Abstract 2015 marks the 27th year that the Lyme Disease Diagnostic Center, located in New York State in the United States, has provided care for patients with suspected or established deer tick-transmitted infections. There are five deer tick-transmitted infectious in this geographic area of which Lyme disease is the most common.For patients with erythema migrans, we do not obtain any laboratory testing. However, if the patient is febrile at the time of the visit or reports rigors and high-grade fevers, we consider the possibility of a co-infection and order pertinent laboratory tests.Our preferred management for ...
Source: Wiener Klinische Wochenschrift - Category: Journals (General) Authors: Tags: Wien Klin Wochenschr Source Type: research
A 51-year-old Hispanic woman with a history of Churg-Strauss syndrome (in remission for 20 years)–associated mesangial glomerulonephritis and end-stage renal disease with a recent renal transplant and previously cured cytomegalovirus (CMV) infection who was on a tapering dose of tacrolimus presented with sudden onset of lower extremity numbness. Symptoms progressed to complete paraplegia and sensory loss over 24 hours. The following day, ascending paresis extended to bilateral upper extremities, with high thoracic sensory level and complete blindness. Initial MRI revealed contrast enhancement of bilateral prechiasmat...
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: EMG, Devic's syndrome, Optic neuritis; see Neuro-ophthalmology/Optic Nerve, Transverse myelitis, Autoimmune diseases Clinical/Scientific Notes Source Type: research
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