This case presentation highlights the significance of contemplating Lyme disease as a doable reason for imaginative and prescient loss and different neurologic signs attributable to nerve and vascular irritation within the head and neck. An 80 yr previous feminine with imaginative and prescient loss, complications, jaw ache, temporal artery tenderness, facial palsy, and limb weak spot underwent an in depth diagnostic workup which included Neurology, Ophthalmology and Rheumatology, however didn’t initially embrace testing for Lyme disease.
The affected person was identified with big cell arteritis, or GCA, after having a temporal artery biopsy. She was handled with corticosteroids.
The affected person lived in a Lyme endemic space, she had many signs of Lyme disease, and her western blot check confirmed 5 constructive bands. She was subsequently handled for Lyme disease.
Of their dialogue, the authors query the first reason for her imaginative and prescient loss just because the affected person declined to have a lumbar puncture.
Because of the affected person’s refusal to endure lumbar puncture for CSF evaluation, a definitive willpower relating to the first etiology of the visible defects stays unsure. The noticed symptomatology raises questions relating to whether or not the visible impairments are primarily attributed to GCA or if Lyme neuroborreliosis is a contributory issue, given the potential overlap of signs.
This case presentation raises questions for additional consideration and analysis. The authors level out earlier instances wherein sufferers have been identified with, or have been initially thought to have had GCA and have been later discovered to have a Lyme an infection. Is it doable that the signs of GCA and imaginative and prescient loss have been each secondary to irritation and immune responses associated to the Lyme an infection? This is a crucial query, as a result of Lyme disease is handled with antibiotics to combat an infection, whereas big cell arteritis is handled with steroids which may suppress the immune response.
This paper illustrates the significance of sharing case shows as a way to higher perceive scientific eventualities just like the one introduced right here. In reviewing this case, one may take into account what this affected person’s course of therapy would have been had she been identified and handled for Lyme disease earlier than receiving the prognosis of big cell arteritis.
This case presentation additionally reiterates the significance of together with Lyme disease within the differential prognosis when contemplating the foundation causes of imaginative and prescient loss and different neurologic signs of Lyme disease.
