A case of chronic progressive lyme encephalitis as a manifestation of XXXX .

@entity1 @entity2756 @entity9144 @entity2414 @entity1296 @entity393 @entity11583 @entity2055
A 54-year-old female living in Europe presented with @entity11583 , @entity1296 , and bilateral @entity393 . Magnetic resonance imaging (MRI) revealed non-specific white matter changes. The @entity1 's condition gradually deteriorated over two years without diagnosis. The @entity1 continued to decline cognitively and neurologically with @entity2055 and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous @entity2756 resulted in marked neurological improvement. Four years after symptom, the @entity1 has short-term @entity2414 and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of @entity9144 in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.
