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Neurological disorder may be the initial manifestation of
Lyme disease. Six cases of neurological
Lyme disease have been seen in the years 1986-89, five of whom contracted the
disease in the West of Ireland. Three presented with a radiculoneuropathy, one with myalgia/fatigue and one with bilateral sixth nerve palsies and ataxia. These cases indicate the spectrum of neurological involvement of
Lyme disease in Ireland which reflects that seen in Europe. They also highlight some of the problems in diagnosis which sometimes necessitate treatment while awaiting serological studies. We feel even in the absence of a history of tick-bite or rash,
Lyme disease should be considered in the differential diagnosis of many neurological disorders, especially in patients from the West of Ireland.