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Diagn Microbiol Infect Dis. 2017 Feb;87(2):163-167. doi: 10.1016/j.diagmicrobio.2016.11.003. Epub 2016 Nov 12.

A critical appraisal of the mild axonal peripheral neuropathy of late neurologic Lyme disease.

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Division of Infectious Diseases, New York Medical College, Valhalla, NY 10595, USA. Electronic address:
Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, 1515, Slovenia.
Departments of Pediatrics, of Epidemiology of Microbial Diseases, and of Investigative Medicine, Yale University, New Haven, CT 06520, USA.
Department of Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA.
Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.


In older studies, a chronic distal symmetric sensory neuropathy was reported as a relatively common manifestation of late Lyme disease in the United States. However, the original papers describing this entity had notable inconsistencies and certain inexplicable findings, such as reports that this condition developed in patients despite prior antibiotic treatment known to be highly effective for other manifestations of Lyme disease. More recent literature suggests that this entity is seen rarely, if at all. A chronic distal symmetric sensory neuropathy as a manifestation of late Lyme disease in North America should be regarded as controversial and in need of rigorous validation studies before acceptance as a documented clinical entity.


Borrelia burgdorferi; Lyme disease; Neuroborreliosis; Neuropathy; Peripheral neuropathy

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