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D. H. K. Jokl; Neurologic Findings Following the Cutaneous Erythema Migrans of Early Lyme Disease: A Five Year Prospective Report. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1459.
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To determine whether patients, all presenting with the erythema migrans (EM) of acute Lyme disease and prior to demonstrating a positive Lyme blood titer would, when followed prospectively for five years, show neurologic or ocular findings.
Within a week following a prescribed course of antibiotics, 12 patients had a complete ophthalmic evaluation which was repeated after one and five years.
Initially, 4/12 (33%) had a transient unilateral facial (VII) nerve paresis with onset 6 days - 2 months following the appearance of the EM and lasting 7 weeks.No further abnormal ocular findings were noted. 7/12 (58%) patients were evaluated up to 5 years from the acute EM onset and none showed ocular abnormalities or sequelae from prior VII nerve paresis. 1/7 (14%) presented with a hypertropia, initially thought due to myesthenia gravis, which proved to be non-progressive.
Immediate antibiotic treatment for acute ( presenting with an EM) Lyme disease had no neurologic or ophthalmic sequelae after 5 years. A transient unilateral facial nerve paresis without late sequelae was seen in 1/3 of treated patients up to 2 months post EM onset.
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