https://www.ncbi.nlm.nih.gov/m/pubmed/29805824/

Ischemic Stroke: Do Not Forget Lyme Neuroborreliosis.

Moreno Legast G, et al. Case Rep Neurol Med. 2018.

Abstract
Lyme neuroborreliosis is a rare cause of ischemic stroke; it has only been described in case reports and mostly in Europe. Diagnostic criteria have been proposed for Lyme neuroborreliosis but the association with a cerebral ischemic presentation is not always straightforward. We here describe the case of an 83-year-old man for whom we strongly suspect Lyme neuroborreliosis as the etiology of his stroke. This case reminds us of the importance of a thorough history taking (i.e., tick bite) and to perform the adequate ancillary tests accordingly (lumbar puncture) so as to propose validated treatment.

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**Comment**

This is rich.  They explain that cerebral ischemic presentation is not always straightforward yet announce with confidence that Lyme is a rare cause of it.  How do you know?  Just because it isn’t bountiful in the literature does not mean isn’t out here.  Remember, the testing only gets about 50% of those infected.  All those folks are misdiagnosed with something else.  Anything but Lyme/MSIDS!   Is anyone even looking for it?  Nope.

Don’t call anything about Lyme/MSIDS rare.  It’s just a matter of time before articles burgeon with all the ways it presents itself.  Until that time, just know, it’s out here – a lot.

Also, please know that one of the only ways Lyme/MSIDS has made the map is by case studies.  Research on all things in Lyme land is abysmal, so take the case studies seriously.