1) Lyme Disease::
Tick... Bites.... Small rodents... Take Bacteria from Small rodents... Than bites human and causes.
Reservoir for Bacteria... Rodents.
Reservoir for Ticks........ White Tail deer.

2) Three Stages of Disease::
STAGE1::
Early localised, occurs after 7-14 days of Bite, Fever, Rash, Headache & Myalgia are prominent. É.Migrans

3) STAGE2::
After weeks, CNS(Subacute Onset, Neuritis, Meningitis, Cranial Nerves), CARDITIS(Myocarditis, Heart Blocks)
Acute Active Arthritis large joints

4) STAGE3::
Months to Years, Chronic Arthritis, Encephalo-Myelitis, Polyneuropathy(axonal) , Mononeuritis Multiplex, Dementia, NeuroPsychiatric sequel.

5) Diagnosis::
ELISA... Looking for Antibodies, If Positive than we go for Blot.If Negative we stop here.
WESTERN BLOT...
IgG 10bands....>5/10... Positive
IgM 3bands.....>2/3......Positive
IgM+IgG... Sx less than 30days
IgG only.... Sx more than 30days.

6) 48% sensitivity in Erythema Migrans(low sensitivity in Early Disease, <30days)
97-100% sensitive in Late Lyme(>30days).
IgG may persist upto 20 years in 25%.

7) Clue to Lyme Meningitis:
Lymphocytic, Subacute Onset(7days),history of Tick Bite or Erythema Migrans, warmer months, wooded area, Nerve palsy like 7 or 8th Nerves, Joint Symptoms, Carditis.

8) Treatment ::
Doxycycline... All patients except Pregnancy and childrens
Amoxycilline.... Pregnant and children
Ceftriaxone, AzithroMycin, cefotaxime are alternative drugs.

9) #Neurology #neurologyresident #neurologist #MedTwitter #NeuroTwitter #meningitis #virus #encephalitis #cns

Neuro-Lyme Disease: MR Imaging Findings

In cases of nerve-root or meningeal enhancement, Lyme disease should be considered in the differential diagnosis in the proper clinical setting

https://pubs.rsna.org/doi/10.1148/radiol.2531081103?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed