01593nam a2200313   4500001000800000005001700008007000300025008004100028040000800069041000800077100004100085245007800126300002500204520054100229650001800770650003300788650003300821650003300854650003200887650003500919650004300954700002800997700002901025700003401054700003301088773011001121942003101231999001701262ESSALUD20260902150357.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aBhattacharyya, Shamik eAutor954423  aCase 15-2026: A 64-Year-Old woman with fatigue, memory changes, and falls  apáginas: 2041-2050  aA 64-year-old woman was admitted to this hospital because of fatigue, memory changes, and falls. The patient had been in her usual state of health until 3 weeks before the current presentation, when fatigue developed during a summer vacation in Maine. She had spent time outdoors near a lake but had had no known tick bites. One week before the current presentation, the patient had increasing fatigue while driving. She parked the car and called her husband, who took her to the emergency department of another hospital for evaluation.  aALERGIA97055  aENFERMEDAD AUTOINMUNE953665  aINMUNOLOGÍA GENERAL953664  aESCLEROSIS MÚLTIPLE914091  aRADIOLOGÍA GENERAL954381  aENFERMEDAD INFLAMATORIA953667  aMEDICINA CLÍNICA HOSPITALARIA953754  aCartmell, Samuel954424  aHung, Albert Y.  954425  aBilodeau, Philippe A. 954426  aConner, Elizabeth C. 9544270 022717922665dMassachusetts NEJM GroupoNEJM013tThe New England Journal of Medicine wESSALUDx0028-4793  cARTICULOSe2026-08-28zsqb  c22890d22890