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  1. Ahmet Z Burakgazi.
    Lyme Disease -Induced Polyradiculopathy Mimicking Amyotrophic Lateral Sclerosis.. The International journal of neuroscience, January 2014.
    Abstract Abstract Importance: To describe a case of predominantly motor polyradiculopathy secondary to Lyme disease that can mimic motor neuron disease and has been rarely reported. Observations: A 64 year-old man presented with a one-month history of rapidly progressive weakness involving bulbar, upper limb and lower limb muscles. The physical examination showed widespread weakness, atrophy, fasciculation and brisk reflexes. The initial electrodiagnostic test showed widespread active and chronic denervation findings. The initial physical and electrodiagnostic findings were suggestive of Amyotrophic Lateral Sclerosis (ALS). However blood serology indicated possible Lyme disease. Thus, the patient was treated with doxycycline. The clinical and electrodiagnostic findings were resolved with the treatment. Conclusion and Relevance: The diagnosis of Lyme disease can be very challenging and it can mimic other neurological disorders such as ALS or Guillain-Barre syndrome (GBS). Careful and detailed examination and investigation are required to confirm the diagnosis and to prevent misleading inaccurate diagnoses.
    URL, DOI BibTeX

    @article{Burakgazi2014,
    	abstract = "Abstract Importance: To describe a case of predominantly motor polyradiculopathy secondary to Lyme disease that can mimic motor neuron disease and has been rarely reported. Observations: A 64 year-old man presented with a one-month history of rapidly progressive weakness involving bulbar, upper limb and lower limb muscles. The physical examination showed widespread weakness, atrophy, fasciculation and brisk reflexes. The initial electrodiagnostic test showed widespread active and chronic denervation findings. The initial physical and electrodiagnostic findings were suggestive of Amyotrophic Lateral Sclerosis (ALS). However blood serology indicated possible Lyme disease. Thus, the patient was treated with doxycycline. The clinical and electrodiagnostic findings were resolved with the treatment. Conclusion and Relevance: The diagnosis of Lyme disease can be very challenging and it can mimic other neurological disorders such as ALS or Guillain-Barre syndrome (GBS). Careful and detailed examination and investigation are required to confirm the diagnosis and to prevent misleading inaccurate diagnoses.",
    	author = "Burakgazi, Ahmet Z",
    	doi = "10.3109/00207454.2013.879582",
    	issn = "1563-5279",
    	journal = "The International journal of neuroscience",
    	month = "jan",
    	pmid = 24397499,
    	title = "{Lyme Disease -Induced Polyradiculopathy Mimicking Amyotrophic Lateral Sclerosis.}",
    	url = "http://www.mendeley.com/research/lyme-disease-induced-polyradiculopathy-mimicking-amyotrophic-lateral-sclerosis/",
    	year = 2014
    }
    
  2. Raphael B Stricker and Lorraine Johnson.
    Lyme disease: the next decade.. Infection and drug resistance 4:1–9, January 2011.
    Abstract Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA) has confirmed the potential for persistent infection with the Lyme spirochete, Borrelia burgdorferi, as well as the complicating role of tick-borne coinfections such as Babesia, Anaplasma, Ehrlichia, and Bartonella species associated with failure of short-course antibiotic therapy. Furthermore, renewed interest in the role of cell wall-deficient (CWD) forms in chronic bacterial infection and progress in understanding the molecular mechanisms of biofilms has focused attention on these processes in chronic Lyme disease. Recognition of the importance of CWD forms and biofilms in persistent B. burgdorferi infection should stimulate pharmaceutical research into new antimicrobial agents that target these mechanisms of chronic infection with the Lyme spirochete. Concurrent clinical implementation of proteomic screening offers a chance to correct significant deficiencies in Lyme testing. Advances in these areas have the potential to revolutionize the diagnosis and treatment of Lyme disease in the coming decade.
    URL, DOI BibTeX

    @article{Stricker2011,
    	abstract = "Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA) has confirmed the potential for persistent infection with the Lyme spirochete, Borrelia burgdorferi, as well as the complicating role of tick-borne coinfections such as Babesia, Anaplasma, Ehrlichia, and Bartonella species associated with failure of short-course antibiotic therapy. Furthermore, renewed interest in the role of cell wall-deficient (CWD) forms in chronic bacterial infection and progress in understanding the molecular mechanisms of biofilms has focused attention on these processes in chronic Lyme disease. Recognition of the importance of CWD forms and biofilms in persistent B. burgdorferi infection should stimulate pharmaceutical research into new antimicrobial agents that target these mechanisms of chronic infection with the Lyme spirochete. Concurrent clinical implementation of proteomic screening offers a chance to correct significant deficiencies in Lyme testing. Advances in these areas have the potential to revolutionize the diagnosis and treatment of Lyme disease in the coming decade.",
    	author = "Stricker, Raphael B and Johnson, Lorraine",
    	doi = "10.2147/IDR.S15653",
    	file = ":C$\backslash$:/Users/riku/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Stricker, Johnson - 2011 - Lyme disease the next decade.pdf:pdf",
    	issn = "1178-6973",
    	journal = "Infection and drug resistance",
    	month = "jan",
    	pages = "1--9",
    	pmid = 21694904,
    	title = "{Lyme disease: the next decade.}",
    	url = "http://www.mendeley.com/catalog/lyme-disease-next-decade/",
    	volume = 4,
    	year = 2011
    }
    
  3. John J Halperin.
    Nervous system lyme disease: is there a controversy?. Seminars in neurology 31(3):317–24, 2011.
    Abstract Infection with the tick-borne spirochete, BORRELIA BURGDORFERI, affects the nervous system in well-defined ways. Accurate diagnostic tools and effective therapeutic regimens are now well established. Persistent misconceptions about (1) the role and interpretation of laboratory tests, (2) what is and is not evidence of nervous system infection, and (3) what constitutes an expected response to treatment have fostered widespread perceptions that this disease is highly controversial. Infection causes the classically described triad of meningitis, radiculoneuritis, and cranial neuritis; however, virtually every known neurologic disorder has been blamed on this infection. For most (multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer disease, Parkinson disease), evidence is scant, nonexistent, or coincidental. For some (cerebral vasculitis with stroke, optic neuritis) a few case reports suggest a rare possible causal link.
    URL, DOI BibTeX

    @article{Halperin2011,
    	abstract = "Infection with the tick-borne spirochete, BORRELIA BURGDORFERI, affects the nervous system in well-defined ways. Accurate diagnostic tools and effective therapeutic regimens are now well established. Persistent misconceptions about (1) the role and interpretation of laboratory tests, (2) what is and is not evidence of nervous system infection, and (3) what constitutes an expected response to treatment have fostered widespread perceptions that this disease is highly controversial. Infection causes the classically described triad of meningitis, radiculoneuritis, and cranial neuritis; however, virtually every known neurologic disorder has been blamed on this infection. For most (multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer disease, Parkinson disease), evidence is scant, nonexistent, or coincidental. For some (cerebral vasculitis with stroke, optic neuritis) a few case reports suggest a rare possible causal link.",
    	author = "Halperin, John J",
    	doi = "10.1055/s-0031-1287652",
    	issn = "1098-9021",
    	journal = "Seminars in neurology",
    	keywords = "Animals,Borrelia,Borrelia: pathogenicity,Humans,Lyme Neuroborreliosis,Lyme Neuroborreliosis: complications,Lyme Neuroborreliosis: diagnosis,Lyme Neuroborreliosis: therapy,Nervous System Diseases,Nervous System Diseases: etiology,Nervous System Diseases: microbiology",
    	language = "en",
    	month = "",
    	number = 3,
    	pages = "317--24",
    	pmid = 21964848,
    	publisher = "© Thieme Medical Publishers",
    	title = "{Nervous system lyme disease: is there a controversy?}",
    	url = "https://www.thieme-connect.de/DOI/DOI?10.1055/s-0031-1287652",
    	volume = 31,
    	year = 2011
    }
    
  4. Muddasir Qureshi, Richard S Bedlack and Merit E Cudkowicz.
    Lyme disease serology in amyotrophic lateral sclerosis.. Muscle & nerve 40(4):626–8, 2009.
    Abstract Lyme disease is sometimes part of the differential diagnosis for amyotrophic lateral sclerosis (ALS). Herein we report on 414 individuals with ALS at the Massachusetts General Hospital who underwent laboratory testing for Lyme disease. Twenty-four (5.8%) were seropositive, but only 4 (0.97%) had confirmed past immunoreactive infection. Two of these patients received ceftriaxone for 1 month without clinical improvement. Lyme disease was rare in 414 patients with ALS and is not likely to be causative.
    URL, DOI BibTeX

    @article{Qureshi2009,
    	abstract = "Lyme disease is sometimes part of the differential diagnosis for amyotrophic lateral sclerosis (ALS). Herein we report on 414 individuals with ALS at the Massachusetts General Hospital who underwent laboratory testing for Lyme disease. Twenty-four (5.8\%) were seropositive, but only 4 (0.97\%) had confirmed past immunoreactive infection. Two of these patients received ceftriaxone for 1 month without clinical improvement. Lyme disease was rare in 414 patients with ALS and is not likely to be causative.",
    	author = "Qureshi, Muddasir and Bedlack, Richard S and Cudkowicz, Merit E",
    	doi = "10.1002/mus.21438",
    	issn = "0148-639X",
    	journal = "Muscle \& nerve",
    	keywords = "Age of Onset,Aged,Amyotrophic Lateral Sclerosis,Amyotrophic Lateral Sclerosis: epidemiology,Amyotrophic Lateral Sclerosis: immunology,Anti-Bacterial Agents,Anti-Bacterial Agents: therapeutic use,Blotting, Western,Ceftriaxone,Ceftriaxone: therapeutic use,Cohort Studies,Enzyme-Linked Immunosorbent Assay,Female,Humans,Immunoglobulin G,Lyme Disease,Lyme Disease: drug therapy,Lyme Disease: epidemiology,Lyme Disease: immunology,Male,Massachusetts,Massachusetts: epidemiology,Middle Aged",
    	month = "",
    	number = 4,
    	pages = "626--8",
    	pmid = 19697382,
    	title = "{Lyme disease serology in amyotrophic lateral sclerosis.}",
    	url = "http://www.ncbi.nlm.nih.gov/pubmed/19697382",
    	volume = 40,
    	year = 2009
    }
    
  5. Y Hänsel, M Ackerl and G Stanek.
    [ALS-like sequelae in chronic neuroborreliosis].. Wiener medizinische Wochenschrift (1946) 145(7-8):186–8, 1995.
    Abstract CSF investigation in a 61-year old female patient with clinical picture of motoneuron disease gave evidence for chronic infection with Borrelia burgdorferi. Improvement of clinical and CSF findings could be observed after antibiotic therapy. The diagnosis of amyotrophic lateral sclerosis which was initially suspected had to be revised and the disorder was interpreted as chronic neuroborreliosis.
    URL BibTeX

    @article{Hansel1995,
    	abstract = "CSF investigation in a 61-year old female patient with clinical picture of motoneuron disease gave evidence for chronic infection with Borrelia burgdorferi. Improvement of clinical and CSF findings could be observed after antibiotic therapy. The diagnosis of amyotrophic lateral sclerosis which was initially suspected had to be revised and the disorder was interpreted as chronic neuroborreliosis.",
    	author = {H\"{a}nsel, Y and Ackerl, M and Stanek, G},
    	issn = "0043-5341",
    	journal = "Wiener medizinische Wochenschrift (1946)",
    	keywords = "Amyotrophic Lateral Sclerosis,Amyotrophic Lateral Sclerosis: diagnosis,Amyotrophic Lateral Sclerosis: etiology,Amyotrophic Lateral Sclerosis: immunology,Antibodies, Bacterial,Antibodies, Bacterial: cerebrospinal fluid,Borrelia burgdorferi Group,Borrelia burgdorferi Group: immunology,Chronic Disease,Diagnosis, Differential,Female,Follow-Up Studies,Humans,Lyme Disease,Lyme Disease: complications,Lyme Disease: diagnosis,Lyme Disease: immunology,Middle Aged,Neurologic Examination,Neurologic Examination: drug effects,Penicillin G,Penicillin G: administration \& dosage,Quadriplegia,Quadriplegia: diagnosis,Quadriplegia: etiology,Quadriplegia: immunology",
    	month = "",
    	number = "7-8",
    	pages = "186--8",
    	pmid = 7610670,
    	title = "{[ALS-like sequelae in chronic neuroborreliosis].}",
    	url = "http://www.ncbi.nlm.nih.gov/pubmed/7610670",
    	volume = 145,
    	year = 1995
    }