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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lyme encephalopathy, primarily manifested by disturbances in memory, mood, and sleep, is a common late neurologic manifestation of Lyme disease. We compared 20 patients with Lyme encephalopathy with 11 fibromyalgia patients and 11 nonpsychotically depressed patients using the California Verbal Learning Test, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Minnesota Multiphasic Personality Inventory (MMPI), and Beck Depression Inventory. Compared with patients with fibromyalgia or depression, the Lyme encephalopathy group showed mild, but statistically significant, memory deficits on two of the three memory tests. In contrast, the patients with fibromyalgia scored significantly higher than both other groups on the MMPI scale most sensitive to somatic concerns (scale 1), while the depressed patients scored higher than the Lyme patients on the scales most sensitive to depression (scale 2) and anxiety (scale 7). Physical complaints and depression were not major factors in memory performance among Lyme patients. These data support the hypothesis that Lyme encephalopathy is caused by CNS dysfunction and cannot be explained as a psychological response to chronic illness.
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PMID:Memory impairment and depression in patients with Lyme encephalopathy: comparison with fibromyalgia and nonpsychotically depressed patients. 162 Mar 29

A complete search of the literature concerning Lyme borreliosis as it relates to horses and cattle was done. The epidemiology, pathogenesis, immunological response to the disease, diagnosis and treatment are discussed. A review of clinical cases in horses and cattle is presented. Clinical signs of Lyme borreliosis in horses include: chronic weight loss, sporadic lameness, laminitis, low grade fever, swollen joints, muscle tenderness, and anterior uveitis. In addition to those clinical signs, neurological signs such as depression, behavioral changes, dysphagia, head tilt and encephalitis can be seen in chronic cases. Borreliosis occurs in cattle, usually as a herd problem. In acute Lyme borreliosis, cattle often will show a fever, stiffness, swollen joints, and decreased milk production. Chronic weight loss, laminitis and abortion are also possible outcomes of borreliosis in cattle. Diagnosis of clinical Lyme borreliosis is difficult and depends upon recognition of clinical signs, a history of possible exposure, and identification of the spirochete in the affected animal. Since the spirochete is very difficult to culture, confirmation of B. burgdorferi infection often relies on serologic testing. Subclinical seropositive animals do occur, thus confusing the diagnosis. An approach to treatment of cattle and horses with Lyme borreliosis is outlined.
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PMID:Lyme borreliosis in cattle and horses: a review of the literature. 164 76

Lyme borreliosis, a tick-borne multisystem disease, may cause a variety of neurologic complications, including meningoencephalitis and encephalopathy. To evaluate neurobehavioral function following treated Lyme borreliosis, 15 patients with Lyme disease and complaints of persistent cognitive difficulty a mean of 6.7 months following antibiotic treatment underwent neuropsychological evaluation and were compared with 10 healthy controls, matched in aggregate for age and education, who underwent the identical neuropsychological assessment. Compared with controls, patients with Lyme disease exhibited marked impairment on memory tests and particularly on selective reminding measures of memory retrieval. The memory impairment did not correlate with serum or cerebrospinal fluid anti-Borrelia burgdorferi antibody titers and was not explained by magnetic resonance imaging findings or depression. The cause of this encephalopathy is currently unknown; however, indirect effects of systemic infection or other toxic-metabolic factors may be partly responsible.
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PMID:Cognitive functioning in late Lyme borreliosis. 141 7

Any patient who has a Bell's palsy (unilateral or bilateral), aseptic meningitis, chronic fatigue syndrome, atypical radiculoneuropathy, presenile dementia, atypical myopathy, or symptoms of atypical rheumatoid arthritis should be asked specifically about the following: visits to highly endemic areas, any known tick bites, any skin lesion suggestive of erythema migrans, any history of palpitations or of prior Bell's palsy, aching in joints (especially the knees), paresthesias, chronic fatigue and depression, forgetfulness, and eye problems. Any patient showing a chronic iritis with posterior synechiae, vitritis in one or both eyes, an atypical pars planitis-like syndrome, big blind spot syndrome, and swollen or hyperemic optic discs should be asked the same questions. The physician should send one red-top tube of blood containing 2 to 3 ml serum to Microbiology Reference Laboratory, 10703 Progress Way, Cypress, CA 90630-4714, requesting a Lyme/treponemal panel. For $90 the patient will receive an RPR test with titer, serum FTA-ABS test, serum Lyme IFA IgG and IgM, and a serum Lyme ELISA test. If these tests are within normal limits and the physician is still suspicious, a Western blot can be ordered on serum. A green top tube with fresh white blood cells sent out by overnight express on a Monday or Tuesday will produce a Lyme PCR and a lymphocyte stimulation test. Finally, R.K. Porschen, director of MRL Laboratory, will provide information on the urine antigen test on an investigational basis. A careful history with emphasis on the specific questions noted above, a complete neuro-ophthalmological and physical examination ruling out other causative problems, and the laboratory studies here discussed will usually provide sufficient data to choose therapy. Much further active research into Lyme borreliosis is an important priority in medicine.
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PMID:Neuro-ocular Lyme borreliosis. 201 Nov 11

Continued efforts are being made to better define the clinical course, disease subsets, and predictors of outcome in scleroderma. Data suggest that the course of the skin disease is triphasic, with the most active thickening phase in the first 12 months of disease. The presence of specific autoantibodies may predict clinical course more precisely than any clinical feature. Antipolymerase I, II, and III antibodies seem specific for scleroderma and, if present, may predict aggressive disease. Early detection of lung involvement provides an opportunity to select patients who may be responsive to drug treatment. Renal crisis in scleroderma is still important and may occur in the absence of significant signs of cutaneous fibrosis. Renin plasma levels do not appear helpful in predicting renal crisis. Significant gastrointestinal reflux disease with delayed acid clearance and esophagitis is associated with aperistalsis of the lower esophagus. Evidence for widespread structural and functional abnormalities of the microvascular circulation have been reemphasized. The psychosocial impact of scleroderma has been studied, demonstrating both the importance of depression and the need for social support. The etiology of localized scleroderma remains unknown despite efforts to link these lesions to Borrelia burgdorferi infection.
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PMID:Clinical aspects of systemic and localized scleroderma. 786 85

A study of literature concerning Lyme borreliosis related to animals was done. In the research work the epidemiology, pathogenesis, diagnosis and treatment of horses, cattle and dogs affected with Lyme borreliosis have been discussed. The clinical signs of Lyme borreliosis in horses are: chronic weight loss, sporadic lameness, laminitis, low grade fever, swollen joints, muscle tenderness and anterior uvetitis. In addition to these clinical sings, neurological sings such as depression, behavioral changes, dysphagia and encephalitis can be seen in chronic cases. Cattle affected with acute Lyme borreliosis often show fever, stiffness, swollen joints and decreased milk production. Chronic weight loss, laminitis and abortion are also a possible outcome of borreliosis in cattle. An early infection of Lyme borreliosis in dogs may give evidence of inapetenca, lethargy, lyphadenopathy, and an acute onset of stiffness or pain while a recurrent intermittent nonerosive arthritis is a more advanced manifestation of canine Lyme borreliosis. Glomerulonephritis and tubular damage secondary to Borrelia burgdorferi infection have been reported to occur in normally infected dogs. In an endemic area atrioventricular heart block has also been reported. The underlying pathogenesis of Lyme disease is still unknown. The diagnosis of clinical Lyme borreliosis is difficult and it depends on a successful recognition of clinical signs, a history of possible exposures to the infection and on serologic testings. The therapy of Lyme borreliosis in animals is based upon the principal therapy of this disease in human medicine.
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PMID:[The importance of Lyme borreliosis in veterinary medicine]. 826 22

A mild chronic encephalopathy may be the most common neurologic symptom in patients with late stage Lyme disease. The symptoms tend to be diffuse and nonspecific, and patients typically report memory loss, sleep disturbance, fatigue, and depression. Among patients with these symptoms, it is generally felt that those with abnormal cerebral spinal fluid (CSF) have a neurological basis to their illness. A comparison of Lyme patients, with and without abnormal CSF, revealed that only the abnormal CSF group had lower memory test scores than normal controls. However, most patients in both Lyme groups complained of memory loss and also reported significantly more symptoms of depression and fatigue than controls. Thus, while depressive symptoms may not be a factor in objective memory performance, they may indeed play a role in perceived memory loss. A survey of the neuropsychological literature suggests that active neurologic involvement, the psychological consequences of chronic illness, and possibly residual neurologic deficits from past infection with Lyme disease all may affect the patient's perception of cognitive dysfunction.
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PMID:Lyme encephalopathy: a neuropsychological perspective. 916 57

This study aimed to estimate some PMN functions, involving phagocytic activity in patients with Lyme borreliosis. Decreased percentage PMN with FcR and CR receptors was observed. Increased immune complexes levels in the serum of patients before, and their normalization after treatment were found. These results indicate a depression of non-specific cellular response, which can influence the general immune system in patients with Lyme borreliosis.
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PMID:[Changes in granulocytic receptors for FcR IgG and CR with circulating immune complexes in patients with lyme borreliosis]. 956 95

Lyme Disease has been called "The New Great Imitator," a replacement for that old "great imitator" neurosyphilis. This article reviews the numerous psychiatric and neurologic presentations found in adults and children. It then reviews the features of Lyme Disease, which makes it almost uniquely hard to diagnose, including the complexity and unreliability of serologic tests. Clinical examples follow that illustrate those presentations of this disease that mimic attention deficit hyperactivity disorder (ADHD), depression, and multiple sclerosis.
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PMID:The underdiagnosis of neuropsychiatric Lyme disease in children and adults. 977 5

This study examined the relation between complaints of memory disturbance and measures of mood and memory functioning in 55 patients with serological evidence of late-stage Lyme Borreliosis (LB). Patients completed the Self-Ratings of Memory Questionnaire (SRMQ) and the Beck Depression Inventory. Memory functioning was assessed with the California Verbal Learning Test. Depressed patients exhibited more frequent complaints of memory disturbance on the SRMQ, although their pattern of responses did not differ from nondepressed patients. There was a significant correlation between subjective memory ratings and self-reported depression (Spearman rho = -.57, p < .001). No relation was observed between subjective memory ratings and objective memory performance. The results indicate subjective complaints of more severe memory disturbance in patients with LB and depression. Particular attention should be paid to the assessment of depression and subjective symptoms of memory disturbance when administering neuropsychological tests of memory functioning in patients with LB.
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PMID:Relations among indexes of memory disturbance and depression in patients with Lyme borreliosis. 1038 66


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