The Neuropsychiatric Assessment of Lyme Disease

Objective: A structured clinical interview is proposed to assist in the overall clinical assessment when late state Lyme disease is suspected.

Method:  From a combination of clinical experience, journal review, and discussion with colleagues, a structured interview was developed. Information from patients with late stage neuropsychiatric Lyme disease (NPLD) was entered into a database to serve as a reference point for diagnosis and tracking the patient’s status after diagnosis.

Results:  An analysis of symptoms acquired from a thorough history and mental status exam can be quite helpful towards the total clinical assessment when suspecting late stage Lyme disease. Details are provided in the text of this article.

Conclusion: When NPLD is a diagnostic possibility, a detailed, well-focused interview and mental status exam is proposed, and a database of symptoms seen in NPLD is established. It is recommended to continue perfecting the assessment as well as expanding the database. If diagnostic accuracy is improved, there would be better consensus regarding treatment strategies.

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