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October 1992

Cognitive Function in Late Lyme Borreliosis

Author Affiliations

175 Main St Mt Kisco, NY 10549

Arch Neurol. 1992;49(10):1011. doi:10.1001/archneur.1992.00530340027010

To the Editor.  —In their article, Krupp et al1 have demonstrated the severity of memory impairments in late Lyme disease. However, the authors failed to consider that the patients examined may have had active Lyme disease at the time of their evaluation.The authors suggested that active infection was no longer present at the time of the cognitive dysfunction based on the lack of a correlation between memory and magnetic resonance imaging findings or between memory and antibody levels in serum or cerebrospinal fluid samples. Krupp et al did not reference their use of antibody level or magnetic resonance imaging findings to show the absence of Lyme disease. Furthermore, the authors did not give reasons why 60% of subjects were not treated with intravenous antibiotics, despite their known efficacy in late Lyme disease.Logigian et al2 have demonstrated that patients with Lyme disease and impairments on neuropsychologic tests

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