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标题：CONTROVERSIES IN A CASE OF NEUROBORELIOSIS VERSUS AMYOTROPHIC LATERAL SCLEROSIS AND METHODS OF RECOVERY
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作者：DOCU AXELERAD ANY ; DANIEL DOCU AXELERAD
期刊名称：Ovidius University Annals, Series Physical Education and Sport/Science, Movement and Health
印刷版ISSN：1224-7359
出版年度：2013
卷号：13
期号：2
页码：603-609
语种：English
出版社：Ovidius University Press
摘要：Purpose.Because of difficulties in making the diagnosis of neuroborreliosis the physician must correlate clinical with laboratory data to confirm the diagnosis.Early on,personality changes,psychiatric symptoms,or cognitive manifestations may be the first,and occasionally the only,symptoms that the patient or family is aware of.Amyotrophic lateral sclerosis (ALS) is the most common degenerative disease of the motor neuron system.The cause of ALS is unknown,although 5-10% of cases are familial.The diagnosis of ALS is primarily clinical.Electro diagnostic testing contributes to the diagnostic accuracy Material and methods: we exam a 63 year patient hospitalized in Neurology Department of Clinical Hospital of Constanta,between 10-20.12.2012.Discussion.Our patient has an history of exposure to B.Burgdorferi one year before the apparition of symptoms.Family describes personality changes and mild cognitive manifestations.We must say that in past history he has an ethanolic abuse.Next symptoms were muscle pain and trouble of gait.It was suspected to have borreliosis and lab results show a little increase of IGM antiborrelia.After one year of antibiotic treatment the gait is worse and appeared trouble of speech and patient was admitted in our department.On clinical examination we found sign of upper and lower motor neuron symptoms.We perform serum immunology and LCR for borrelia was norm,MRI cerebral and cervical scan was normal,EMG show fasciculation and fibrillation potentials.We begin a neuromotor and physiologic rehabilitation.Conclusions: it is important if the symptoms are not clear and the results of immunology is not complete to not begin treatment for borreliosis and the interdisciplinary consult is necessary to complete the diagnosis.After antibiotic treatment we observe that clinical sign worst.
关键词：neuroboreliosis;amyotrophic lateral sclerosis;differential diagnosis