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Teenager with stroke-like symptoms had Lyme: Acute Lyme Neuroborreliosis With Transient Hemiparesis and Aphasia

DOI: https://dx.doi.org/10.1016/j.annemergmed.2015.01.011

February 25, 2015

Nervous system involvement in Lyme disease often mimics other conditions and thus represents a diagnostic challenge, especially in an emergency department setting. We report a case of a female teenager presenting with sudden-onset aphasia and transient right-sided faciobrachial hemiplegia, along with headache and agitation. Ischemia, vasculitis, or another structural lesion was excluded by brain imaging. Toxicologic evaluation results were negative. Cerebral perfusion computed tomography and electroencephalography showed left parietotemporal brain dysfunction. Lumbar puncture result, although atypical, suggested bacterial infection …

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  1. “The patient received intravenous antibacterial and antiviral agents (ceftriaxone, amoxicillin/clavulanate, and acyclovir). Substantial improvement was observed immediately after treatment initiation.”

    “The report highlights the importance of lumbar puncture and early empiric antimicrobial treatment.”

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