(Kiosk 3) Acute Rehabilitation Course of a Patient with Lyme Disease Presenting as Guillain–barré Syndrome: A Case Report

Case Diagnosis: A 29-year-old African American female with no prior past medical history who was hospitalized with Lyme disease presenting as Guillain–Barré syndrome (GBS).

Case Description or Program Description: Patient was admitted to an acute inpatient rehabilitation facility after a hospitalization during which patient was found to ascending weakness/numbness and Bell’s Palsy. She was found to be IgM+ for Borrelia Burgdorferi; but also displayed symptoms correlating with GBS. Due to this circumstance, she was treated with both a course of IVIG to cover GBS, and oral doxycycline which she continued throughout her rehab stay. On admission to the rehabilitation unit, patient had significant upper and lower extremity weakness bilaterally throughout. She had depressed reflexes throughout and decreased sensation in her distal upper and lower extremities. She also had urinary incontinence as well. She was requiring total assistance for all transfers via a patient lift. She also was total assistance for ADLs as well.

Setting: Inpatient Rehabilitation Facility

Assessment/Results: Patient made a significant recovery during her 21 day stay on the rehabilitation unit. She was able to regain urinary continence towards the end of her stay. She made excellent recovery in motor function. She met all her goals with both occupation and physical therapy. She was ambulating over 150 feet with a rolling walker and minimum assistance. She was completing most all her ADLs independently, and she was contact guard assistance for transfers.

Discussion (relevance): This is the 1st reported case, to our knowledge, describing the rehabilitation course of a patient with Lyme Disease presenting as Guillain-Barre Syndrome.

Conclusions: Acute Rehabilitation in the setting of patient with Lyme Disease Presenting as Guillain–Barré Syndrome may dramatically expedite the functional recovery timeline.