Challenging Diagnosis and Inpatient Rehabilitation of Acute Bilateral Neuralgic Amyotrophy Possibly Attributed to Lyme Disease: A Case Report

In this report, we discuss the diagnosis, electrodiagnostic progression, pain management, goals for inpatient rehabilitation, and overall prognosis of NA.Level of EvidenceV
Source: PMandR - Category: Rehabilitation Source Type: research

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Discussion Bradycardia is a heart rate below what the lowest value that is normal for age. Infants and children have higher heart rates that slowly decrease with age to adult levels. It is usually noted as an incidental finding because of increased vagal tone. Reasons for cardiology referral include associated heart murmur, syncope especially if associated with exercise or unusual triggers, other signs such as chest pain or palpitations, family history of sudden cardiac death, congenital heart disease or familial heart disease, bradycardic medication use, or unusual symptoms associated with the concern. Severe bradycardia ...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Written by Pendell Meyers(with really great and thorough explanation of this finding by Ken Grauer).At my hospital, patients with any symptoms which could be vaguely interpreted as a possible stroke during the triage process are brought to the high acuity area and a provider is asked to do a " neuro check " , which involves a quick H and P and exam to determine if we should activate our stroke protocol.A man in his 70s was brought to me for a neuro check, and the triage providers commented that they were worried about a possible seizure as well. The patient was alert and oriented with normal vitals at triage. He ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
BOSTON (CBS) — Looking back at baby pictures reminds Brandi Dean of a terrifying scare during her second pregnancy. It turns out the Wellesley mom had Lyme disease. “All of a sudden, the right side of my body was completely numb. My heart was racing. I was disoriented and I said, ‘I think you need to take me to the hospital,’” she remembered. After the standard antibiotic treatment, Dean still didn’t feel right. “I’d gone to 12 different specialists and they all had diagnosed me with anxiety.” She had what the Centers for Disease Control calls Post-Treatment Lyme Syndro...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health Healthwatch Syndicated Local Dr. Mallika Marshall LYME DISEASE spaulding hospital Source Type: news
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
I was speaking with someone recently who has a series of chronic and painful conditions; some of which are noticeable and some ‘invisible’. What is particularly distressful is that people sometimes say to her, “At least you don’t have cancer.” How dismissive is that? I know they are trying to help her feel better about what she does have and perhaps even attempt to minimize the impact, but it is not compassionate or helpful. There are diagnoses such as fibromyalgia, lupus, diabetes, arthritis or neuropathy which some people have to navigate. It might mean taking naps on an as-needed basis, en...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Chronic Pain Health-related Inspiration & Hope Personal Arthritis Chronic Illness Diabetes Fibromyalgia Lupus Lyme disease neuropathy peer support Source Type: blogs
Patients with a mental health condition might have a hard time accessing opioids for pain relief, while patients with unexplained pain are often referred to psychiatric care, which does little to alleviate their symptoms. Finding treatment can be frustrating and humiliating. Four years ago, Dez Nelson’s pain management clinic demanded that she complete a visit with a psychologist. Nelson was surprised, since she had no history of mental illness, but she didn’t feel that she could push back on the request. “Of course I said okay — I didn’t want to lose my treatment,” Nelson told The Fix. ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Addiction Disorders Health-related Medications Mental Health and Wellness Publishers Substance Abuse The Fix Treatment Chronic Pain mental health and pain Opioids Pain Management pain management clinic Pain Relief pain treatm Source Type: blogs
Authors: Ranque-Garnier S, Eldin C, Sault C, Raoult D, Donnet A Abstract Lyme disease is caused by bacteria of the B. burgdorferi sensu lato complex, and can give polymorphic clinical manifestations that can affect several organs such as the skin, the central nervous system, or the joints. In recent years, patients' associations and physicians have been supporting the hypothesis that this infection would manifest as chronic generalized musculoskeletal pain symptoms, named "chronic Lyme disease". Fibromyalgia is a clinical presentation characterized by chronic generalized musculoskeletal pain with a m...
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research
We report a 37-year-old female with systemic lupus erythematosus (SLE) who was repeatedly misdiagnosed for a chronic Lyme disease and treated with tetracycline antibiotics before she developed an acute exacerbation of SLE and finally died due to multi-organ failure.The internet encourages patients to ask physicians for serology testing for Lyme disease and to demand further antibiotic treatment. However, there is clear evidence that positive serology does not indicate infection with B.burgdorferi and most importantly, antibiotic therapy for PTLDS is potentially harmful for patients.It is crucial to follow the recent guidel...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
Purpose of review To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients. Recent findings The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent revi...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research
Septic arthritis is a dangerous medical condition associated with significant morbidity and mortality. However, the differential diagnosis can be broad with conditions that mimic this disease and require different evaluation and treatment. This narrative review presents the emergency medicine evaluation and management, as well as important medical conditions that may mimic this disease. Septic arthritis commonly presents with monoarticular joint pain with erythema, warmth, swelling, and pain on palpation and movement. Fever is present in many patients, though most are low grade. Blood testing and imaging may assist with th...
Source: Western Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
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