This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Lyme disease (LD), a systemic infection caused by the tick-borne spirochaete Borrelia burgdorferi, is characterized by a rash (erythema migrans) associated with musculoskeletal, neurologic, and cardiac abnormalities. LD is endemic in the United States in the northeast, the upper midwest, and northern California, and Oregon, and in forested regions of Europe. Its incidence continues to rise, but progress has been made in educating the public to reduce risk of exposure, in achieving early diagnosis, and in treating the disease effectively.
After treatment, some patients continue to complain of nonspecific symptoms such as fatigue, difficulty in sleeping, cognitive impairment, headache, arthralgia, and myalgia. Symptoms are usually not associated with objective findings or biological markers. Hence, there is no formal definition of post Lyme disease (PLD) and no agreement on its diagnostic criteria. The condition remains a boggling enigma.2,3⇓ Although in Europe the initial infection tends to be much more disseminated by the time of introduction of antibiotic therapy (attributed to genetic differences between European and American strains causing less …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Use of Whole-Genome Sequencing for Mitochondrial Disease Diagnosis
Dr. Robert Pitceathly and Dr. William Macken
► Watch
Topics Discussed
Alert Me
Recommended articles
Clinical Practice Guidelines by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology
Practice Parameter: Treatment of nervous system Lyme disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Study and treatment of post Lyme disease (STOP-LD)
Practice parameters for the diagnosis of patients with nervous system Lyme borreliosis (Lyme disease)