Acute @entity11438 due to XXXX .

@entity1 @entity3001 @entity11438 @entity16 @entity425 @entity158 @entity4841 @entity10 @entity12761 @entity221
OBJECTIVE: to describe acute @entity11438 as the initial manifestation of @entity3001 . BACKGROUND: bilateral, predominantly motor, cervical @entity16 , the "dangling arm syndrome," has not been reported as a complication of acute Lyme infection. METHODS: retrospective series of 5 @entity1 from 2 tertiary neuromuscular centers. RESULTS: there were 4 @entity1 and 1 @entity1 with an average age of 69 years. One recalled a tick bite, and preceding constitutional symptoms included @entity10 (2) and @entity221 , @entity4841 , and fatigue in 1 @entity1 each. Proximal arm @entity425 and @entity12761 developed within 3 weeks from onset; @entity158 was bilateral in 3 @entity1 and unilateral in 2 @entity1 , and was described as severe throbbing. Arm @entity425 was bilateral at onset in 3 @entity1 , and right sided in 2 @entity1 followed by spread to the left arm within days. All the @entity1 had @entity425 in the deltoid and biceps that was 3/5 or less (Medical Research Council scale), with variable @entity425 of the triceps and wrist extensors; 1 @entity1 had a flail right arm and moderate (4/5) @entity425 of the proximal left arm muscles. Light touch was normal in the regions of @entity425 , and 1 @entity1 had mildly reduced pin sensation over the forearm. Serum IgM Lyme titers were elevated in all the @entity1 and were detected in the cerebrospinal fluid in 4 tested @entity1 . The cerebrospinal fluid protein ranged between 135 and 176 mg/dL with lymphocytic pleocytosis (range, 42 to 270 cells). Electrodiagnostic studies showed normal median and ulnar motor potentials with asymmetrically reduced sensory amplitudes in the median (4), ulnar (3), and radial, and lateral antebrachial cutaneous potentials in 1 @entity1 each. Two @entity1 had acute denervation in the cervical or proximal arm muscles. There was full recovery after antibiotic therapy in 4 @entity1 and considerable improvement in 1 @entity1 after 2 months. CONCLUSION: acute @entity11438 is a rare manifestation of acute Lyme infection and responds promptly to antibiotic therapy.
