Case 77: Painful Small Fiber Neuropathy in Posttreatment Lyme Disease Syndrome

Abstract

This case illustrates autonomic failure in painful post-Lyme disease syndrome. Autonomic testing has shown supine hypertension, orthostatic hypotension, and hypocapnic cerebral hypoperfusion (HYCH). Small fiber neuropathy was painful, affecting sensory fibers. Patient noted improvement in the pain by about 40% after 12 month of intravenous immune globulins.