Do you routinely order MRI or perform lumbar puncture in patients with peripheral neuropathies secondary to Lyme disease to inform staging, duration, and modality of treatment?

The short answer is definitely no. If this is a true neuropathy, on examination, an MRI adds nothing (it will be negative). A lumbar puncture may be mildly abnormal (as with ANY neuropathy), revealing elevated protein and a small number of lymphocytes. This result does not change the treatment. I us...