Case 74: Small Fiber Neuropathy and Lyme Disease

Autonomic Testing ◽

10.1093/med/9780190889227.003.0079 ◽

2019 ◽

pp. 378-381

Author(s):

Peter Novak

Keyword(s):

Lyme Disease ◽

Small Fiber Neuropathy ◽

Small Fiber

Dizziness, numbness, and pain can be associated with small fiber neuropathy and hypocapnic hyperventilation. Lyme disease can be the underlying cause.

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Small fiber neuropathy following vaccination for rabies, varicella or Lyme disease

Vaccine ◽

10.1016/j.vaccine.2009.09.077 ◽

2009 ◽

Vol 27 (52) ◽

pp. 7322-7325 ◽

Cited By ~ 19

Author(s):

Nizar Souayah ◽

Senda Ajroud-Driss ◽

Howard W. Sander ◽

Thomas H. Brannagan ◽

Arthur P. Hays ◽

...

Keyword(s):

Lyme Disease ◽

Small Fiber Neuropathy ◽

Small Fiber

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Case 77: Painful Small Fiber Neuropathy in Posttreatment Lyme Disease Syndrome

Autonomic Testing ◽

10.1093/med/9780190889227.003.0082 ◽

2019 ◽

pp. 390-393

Author(s):

Peter Novak

Keyword(s):

Lyme Disease ◽

Orthostatic Hypotension ◽

Autonomic Failure ◽

Small Fiber Neuropathy ◽

Cerebral Hypoperfusion ◽

Supine Hypertension ◽

Autonomic Testing ◽

Small Fiber ◽

Immune Globulins ◽

Sensory Fibers

This case illustrates autonomic failure in painful post-Lyme disease syndrome. Autonomic testing has shown supine hypertension, orthostatic hypotension, and hypocapnic cerebral hypoperfusion (HYCH). Small fiber neuropathy was painful, affecting sensory fibers. Patient noted improvement in the pain by about 40% after 12 month of intravenous immune globulins.

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Case 61: Small Fiber Neuropathy, Patchy, with Elevated Voltage-Gated Potassium Channel Antibodies

Autonomic Testing ◽

10.1093/med/9780190889227.003.0066 ◽

2019 ◽

pp. 324-327

Author(s):

Peter Novak

Keyword(s):

Chronic Pain ◽

Lyme Disease ◽

Potassium Channel ◽

Chronic Fatigue ◽

Small Fiber Neuropathy ◽

Cerebral Hypoperfusion ◽

Sensory Threshold ◽

Voltage Gated ◽

Small Fiber ◽

History Of

This patient presents with disabling pain in the feet for several years, chronic fatigue, and a history of Lyme disease. Neuropathy workup revealed autoimmune small fiber neuropathy with patchy distribution, associated with voltage-gated potassium channel antibodies (VGKC) antibodies. VGKCs modulate the nociceptive sensory threshold. Severe hypocapnic hyperventilation in this patient may be related to chronic pain and cerebral hypoperfusion.

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Case 76: Small Fiber Neuropathy, Hypocapnic Cerebral Hypoperfusion, and Posttreatment Lyme Disease Syndrome

Autonomic Testing ◽

10.1093/med/9780190889227.003.0081 ◽

2019 ◽

pp. 386-389

Author(s):

Peter Novak

Keyword(s):

Lyme Disease ◽

Small Fiber Neuropathy ◽

Cerebral Hypoperfusion ◽

Small Fiber

This chapter describes posttreatment Lyme disease syndrome (PLDS) that can be associated with mild adrenergic failure, small fiber neuropathy, and hypocapnic cerebral hypoperfusion during the tilt.

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Case 75: Small Fiber Neuropathy, Cerebral Autoregulatory Failure, and Posttreatment Lyme Disease Syndrome

Autonomic Testing ◽

10.1093/med/9780190889227.003.0080 ◽

2019 ◽

pp. 382-385

Author(s):

Peter Novak

Keyword(s):

Lyme Disease ◽

Small Fiber Neuropathy ◽

Autonomic Testing ◽

Small Fiber ◽

History Of

This patient has a history of Lyme disease with persistent cognitive and sensory symptoms, and he may have posttreatment Lyme disease syndrome (PLDS). The autonomic testing showed small fiber neuropathy and cerebral autoregulatory failure.

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