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Previous Volume 356:1561-1570 April 12, 2007 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 59-year-old man was admitted to this hospital in late summer because of back pain, weakness in the right arm, and cranial-nerve palsies.

The patient was in his usual state of health until the first week in July, 5 weeks before admission, when fevers led to body temperatures up to 39.4°C and neck stiffness developed. He saw his primary care physician, who noted thrombocytopenia; a viral illness was diagnosed, and antibiotics were administered. The fevers resolved within 5 days after they started, and the platelet count returned to normal within 2 weeks. However, the discomfort in his neck gradually worsened. . . . [Full Text of this Article]

Differential Diagnosis

Autoimmune Disorders

Inflammatory Disorders

Infectious Disorders

Neoplastic Disorders

Pathological Discussion

Manifestations of Neuroborreliosis

Clinical Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis

Source Information

From the Departments of Neurology (D.M.G., S.R.P.), Radiology (P.W.S.), and Pathology (R.P.H.), and the Division of Rheumatology, Allergy and Immunology (A.C.S.), Massachusetts General Hospital; and the Departments of Neurology (D.M.G., S.R.P.), Radiology (P.W.S.), Pathology (R.P.H.), and Medicine (A.C.S.), Harvard Medical School.

Related Letters:

Case 11-2007: Neck Pain, Weakness, and Cranial-Nerve Palsies
Singh N. K., Alkhatib A. A., Elkhatib F. A., Greer D. M.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:197, Jul 12, 2007. Correspondence

This article has been cited by other articles:

• Hurley, R. A., Taber, K. H. (2008). Acute and Chronic Lyme Disease: Controversies for Neuropsychiatry. J. Neuropsychiatry Clin. Neurosi. 20: iv-6 [Full Text]  
• Singh, N. K., Alkhatib, A. A., Elkhatib, F. A., Greer, D. M. (2007). Case 11-2007: Neck Pain, Weakness, and Cranial-Nerve Palsies. NEJM 357: 197-197 [Full Text]