Left prefrontal cortex high frequency deep TMS for neuropsychiatric symptoms of lyme disease: Case report

Ocular manifestations of Lyme disease (LD) remain a rare feature of the disease, but it may present a wide range of clinical presentations with different combinations. LD related optic neuritis or cranial nerve (CN) six palsy have been reported in the literature. However, this is the first case report of simultaneous involvement of CN 2 and CN 6 in a patient with LD. The diagnosis of LD can be challenging and initial laboratory tests can be a false negative. It is paramount important to repeat the diagnostic test if clinical suspicious is ongoing. With this case, we aim to increase awareness of clinicians for possible ocular manifestations of LD and its complex diagnostic process.

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Dementia in Parkinson's disease: Case report

European Psychiatry ◽

10.1016/s0924-9338(11)72551-2 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 846-846

Author(s):

S.G. Oliveira ◽

S.M. Pereira ◽

J. Mendes

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Case Report ◽

Psychiatric Hospitalization ◽

Psychological Symptoms ◽

Neuropsychiatric Symptoms ◽

Diagnostic Testing ◽

Visual Hallucinations ◽

Psychomotor Agitation ◽

Disease Case

IntroductionParkinson's disease (PD) dementia is a rapidly growing global health problem. Dementia in PD is often accompanied with neuropsychiatric manifestations, such as depression, insomnia, visual hallucinations and psychomotor agitation, which need psychiatric attention.ObjectivesThe authors’ aim is to report a case of a 76-year-old female suffering from PD who was admitted to the psychiatric yard exhibiting neuropsychiatric symptoms. A literature's review about PD dementia was also made.Case reportPatient had one psychiatric hospitalization at age 41, due to depressive symptoms. PD diagnose was made at age 65 and initially responded well to levodopa. Over the subsequent years, motor fluctuations and dyskinesias as well as autonomic, cognitive and psychological symptoms gradually developed. At 75 years, patient's family stated that she had been more forgetful, impulsive, showing signs of anxiety and dysphoria. She was hospitalized exhibiting psychomotor agitation, disorientation, insomnia and mainly nocturnal visual hallucinations with persons. Diagnostic testing included: cranial tomography which showed mild generalized atrophy but no other structural cause of her symptoms; laboratory tests with B12, folic acid, thyroid function; syphilis detection test and examinations of serum and urine were normal. The MMSE scored 19. Attention deficits and constructional apraxia were present in clock drawing test. Treatment was initiated with memantine and a low dose of quetiapine. She was discharged after 20 days with improvement of neuropsychiatric symptoms.ConclusionsEarly diagnosis and treatment of dementia in PD may prevent psychiatric hospitalization and avoid patient's and family's distress.

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Deep rTMS for Neuropsychiatric Symptoms of Huntington's Disease: Case Report

Brain Stimulation ◽

10.1016/j.brs.2016.09.002 ◽

2016 ◽

Vol 9 (6) ◽

pp. 960-961 ◽

Cited By ~ 2

Author(s):

Molly Davis ◽

Angela Phillips ◽

Aron Tendler ◽

Angela Oberdeck

Keyword(s):

Case Report ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Neuropsychiatric Symptoms ◽

Disease Case

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Lyme disease: case report of persistent Lyme disease from Pulaski County, Virginia

International Medical Case Reports Journal ◽

10.2147/imcrj.s51240 ◽

2013 ◽

pp. 99 ◽

Cited By ~ 11

Author(s):

James Palmieri ◽

Scott King ◽

Arben Santo ◽

Matthew Case

Keyword(s):

Case Report ◽

Lyme Disease ◽

Disease Case

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Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.505941 ◽

2021 ◽

Vol 12 ◽

Author(s):

Amy Cross ◽

Denis Bouboulis ◽

Craig Shimasaki ◽

Charles Ray Jones

Keyword(s):

Case Report ◽

Lyme Disease ◽

Neuropsychiatric Symptoms ◽

The United States ◽

Intravenous Immunoglobulins ◽

Streptococcal Pharyngitis ◽

Serological Evidence ◽

Disease Exposure ◽

Clinical Diagnostic Criteria

This case report describes the diagnosis and treatment of a pre-pubertal (onset at age 7) Caucasian female with serological evidence of Lyme disease accompanied by multiple neuropsychiatric symptoms 6 months following a vacation in a tick endemic area of the United States. Prior to the diagnosis of Lyme disease, the patient also met the clinical diagnostic criteria for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep), with serological evidence of three distinct episodes of streptococcal pharyngitis. All three episodes of strep occurred during the 6-months interval between suspected Lyme disease exposure and the onset of multiple neuropsychiatric symptoms. Her sometimes incapacitating symptoms followed a relapsing and remitting course that impacted her personal, family, social, and academic domains. Over a span of 31 consecutive months of treatment with various antimicrobials and three courses of intravenous immunoglobulins (IVIg) she experienced complete remission and remains symptom free at the time of this publication. Written permission was obtained from the minor patient's mother allowing the submission and publication of this case study.

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Lyme disease: case report and review

Clinical Eye and Vision Care ◽

10.1016/s0953-4431(99)00019-3 ◽

1999 ◽

Vol 11 (2) ◽

pp. 89-95 ◽

Cited By ~ 1

Author(s):

James E Stottlemyer O.D

Keyword(s):

Case Report ◽

Lyme Disease ◽

Disease Case

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The Ultimate Poker Face: A Case Report of Facial Diplegia, a Guillain-Barré Variant

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.2.45556 ◽

2020 ◽

Vol 4 (2) ◽

pp. 150-1523

Author(s):

Joshua Lowe ◽

James Pfaff

Keyword(s):

Emergency Department ◽

Cerebrospinal Fluid ◽

Case Report ◽

Lyme Disease ◽

Intravenous Immunoglobulin ◽

Facial Palsy ◽

Facial Diplegia ◽

Disease Case ◽

Standard Of Practice ◽

Guillain Barré

Introduction: Facial diplegia, a rare variant of Guillain-Barré syndrome (GBS), is a challenging diagnosis to make in the emergency department due to its resemblance to neurologic Lyme disease. Case report: We present a case of a 27-year-old previously healthy man who presented with bilateral facial paralysis. Discussion: Despite the variance in presentation, the recommended standard of practice for diagnostics (cerebrospinal fluid albumin-cytological dissociation) and disposition (admission for observation, intravenous immunoglobulin, and serial negative inspiratory force) of facial diplegia are the same as for other presentations of GBS. Conclusion: When presented with bilateral facial palsy emergency providers should consider autoimmune, infectious, idiopathic, metabolic, neoplastic, neurologic, and traumatic etiologies in addition to the much more common neurologic Lyme disease.

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