TAILIEUCHUNG - THE UNDERDIAGNOSIS OF NEUROPSYCHIATRIC LYME DISEASE IN CHILDREN AND ADULTS

Regarding information sharing, at national level, VNRC regularly collects information regarding the HFMD situation at province and national level for a clearer picture about current updates, affected areas and trends. At provincial level, chapters are also engaging with health sectors in tackling the wide spread of HFMD. Active chapters in provinces where CBHFA is implemented such as Ben Tre and Tien Giang have been successfully secured government funding to implement training for volunteers and community-based education and prevention. In Ben Tre and Tien Giang, each chapter was able to train about 100 volunteers for distribution of HFMD messages. | DIAGNOSTIC DILEMMAS PART I 0193-953X 98 .00 THE UNDERDIAGNOSIS OF NEUROPSYCHIATRIC LYME DISEASE IN CHILDREN AND ADULTS Brian A. Fallon MD MPH Janice M. Kochevar NP Andrea Gaito MD and Jenifer A. Nields MD Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi. Reported throughout the United States the greatest incidence of Lyme disease occurs in certain areas such as the Northeast the upper Midwest and the Pacific Coastal states. It has been dubbed The New Great Imitator because like another spirochetal illness neurosyphilis the original Great Imitator Lyme disease has a vast array of multisystem manifestations including neuropsychiatric ones. Failure to recognize Lyme disease early in its course can result in the development of a chronic illness that is only temporarily or partially responsive to antibiotic therapy. The goal of this article is to present the typical and atypical manifestations of Lyme disease in children and adults in order to help the clinician more rapidly unmask the correct diagnosis behind the puzzling presentations of some patients. THE DIAGNOSTIC PROBLEM Whenever a disease exists for which serologic tests are unreliable in determining the presence or absence of the disease process frustration and anxiety rise among both patients and doctors. When controversy exists even among the This work has been supported by the Lyme Disease Association of New Jersey and the Betz Family. From the Department of Psychiatry Columbia University Medical Center and the Lyme Disease Research Program New York New York BAF private practice Armonk New York JMK Department of Medicine Seton Hall University and private practice. Basking Ridge New Jersey AG and Department of Psychiatry Yale University School of Medicine New Haven Connecticut JAN THE PSYCHIATRIC CLINICS OF NORTH AMERICA VOLUME 21 NUMBER 3 SEPTEMBER 1998 693 694 FALLON et al leading academic researchers as to the validity and reliability of these tests a battleground is

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