What Are The Symptoms Of Post
Doctors have known for years that they cannot rely on a physical exam to diagnose early Lyme disease unless they find an erythema migrans rash, Bells palsy, or heart block. Now, Rebman and colleagues from the Johns Hopkins University School of Medicine acknowledge that doctors also cannot count on a physical exam to diagnose Post-treatment Lyme disease syndrome .
In their article published in the journal Frontiers in Medicine, the authors state, Results from the physical exam and laboratory testing our sample of patients with PTLDS did not show a pattern of significant objective abnormalities. However, the most notable exception was the higher rate of diminished vibratory sensation on physical exam among participants with PTLDS.
Following treatment for Lyme disease, it is uncommon to find objective clinical manifestations in patients with PTLDS, according to the researchers. In fact, a much more likely scenario after treatment is the persistence or development of subjective symptoms without any residual or new objective manifestation.
But the authors did discover a collection of symptoms among the Lyme disease patients which, when looked at as a whole, indicated the presence of problems post-treatment. For example, Although only found in a small subset of our sample , two participants met criteria for postural orthostatic tachycardia syndrome, an autonomic condition that has been previously reported following Lyme disease.
Chronic Lyme: What Happens When Lyme Goes Untreated
The Lyme community typically uses the term chronic Lyme disease to describe a range of physical, cognitive, and emotional symptoms that crop up after getting Lyme disease and persist for months to years after infection.
The risk of chronic Lyme increases the longer a Lyme infection goes untreated or undertreated. In other words, patients are more likely to recover fully if their Lyme infection is detected and treated as early as possible after the discovery of a tick bite. This stage is usually marked by symptoms such as fevers, chills, muscle aches, and sometimes rashes.
When left untreated or undertreated, however, Lyme disease can spread throughout the body and affect:
- The central nervous system
- Muscles and joints
As Lymedisease.org points out, these symptoms can evolve, disappear, and reappear at different times.
Treating Balance Issues In Lyme Disease
The only way to treat Lyme disease is through the use of antibiotics. Often, those with neurological issues caused by Lyme disease have a difficult time overcoming symptoms, even with treatment. This is why vestibular rehabilitation may be necessary to address issues with balance and restore a person back to their full abilities.
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The Numbers On Chronic Lyme
Because Lyme disease is commonly missed or misdiagnosed, statistics vary on how many Lyme patients go on to experience chronic symptoms. The following research nonetheless paints a basic picture of the problem.
- An estimated 5-20% of patients may have chronic symptoms after getting Lyme disease, according to the Columbia University Irving Medical Center.
- The treatment failure rate for chronic Lyme disease patients was estimated at 26-50% in 2004, compared to 16-39% for early Lyme patients, according to Lymedisease.org.
- Up to 15-40% of late-stage Lyme patients develop neurological disorders, which are responsible for many common symptoms of chronic Lyme disease.
Experts dont know for sure why some people experience persistent symptoms, even with treatment. However, some believe the Lyme infection may trigger an auto-immune response that manifests in the chronic symptoms detailed below.
What Is Lyme Disease
Lyme disease is a condition transmitted from the bite of a black-legged or deer tick. When a tick attaches to you, it can transfer a spirochete bacterium called Borrelia burgdorferi. The longer the tick is on you, the more likely you are to get Lyme disease.
Ticks live in areas lush with tall grasses and woods. Theyre most common in the Northeast and upper Midwest of the United States. Anyone is susceptible to Lyme disease. There are at least
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Abnormal Sensations In The Limbs
A possible complication of Lyme disease is peripheral neuropathy, which signals dysfunction in the communication between nerves. Lyme-related neuropathy can cause odd sensations in different parts of the body, especially the limbs. Some people feel sharp, stabbing pains, burning sensations, tingling, and even numbness.These symptoms are common to many diseases, which is one more reason affirmative Lyme disease diagnoses are often delayed.
General Signs And Symptoms Of Lyme Disease:
The clinical course of Lyme begins with a skin lesion , several days after a tick bite. After this, neurological, cardiac, chronic skin, or joint involvement develops. Similar to the situation with syphilis, Lyme is divided into several stages — an acute localized one, with later dissemination divided into early and late stages.
In the late stage , there may be chronic encephalomyelitis. Patients present with spastic paraparesis, ataxia, cranial nerve palsies such as facial weakness and deafness, bladder dysfunction, and cognitive impairment.
According to Garcia-Monco , the most common clinical presentations are painful radiculitis, cranial palsy , and headache. Thus these are symptoms primarily of nerve damage. In the US, lymphocytic meningitis is the most common and single early manifestation. Headache is the main complaint.
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When To See A Healthcare Provider
Since Lyme disease can take different forms, and since its often confused with other conditions, its important to be proactive if you suspect the condition. What signs prompt medical help? Call the healthcare provider if:
- You have a bullseye rashor any kind of rashfollowing a tick bite.
- You experience flu-like symptoms after a tick bite.
- You experience symptoms of more advanced Lyme disease: arthritis, heart palpitations, facial paralysis, dizziness, and others.
Complications Of Untreated Lyme Disease
If unchecked, the Lyme disease infection can spread to other bodily systems, causing significant damage. Untreated, complications of this condition can be very severe:
- Arthritis:Prolonged infection with Lyme disease leads to chronic joint inflammation and swelling, usually in the knees . These symptoms tend to arise within two years of infection, with periods of flare-ups and remissions. This arthritis is relatively difficult to manage, though antibiotics and steroids may be attempted.
- Lyme carditis:If the bacteria reach the heart tissues, they can cause inflammation and lead to heart block. The electrical signals being sent between the upper and lower chambers of the heart are interrupted, impairing the coordination of the heartbeat. Though disruptive, this is rarely fatal.
- Lyme neuroborreliosis:Inflammation of multiple nerves, including those in the spine and brain, is the chief characteristic of this condition. This can also affect the meningesthe layer of tissue surrounding the brain and spineleading to meningitis, among other conditions. Antibiotic therapy, if applied promptly, tends to be effective as a treatment.
Even in cases where Lyme disease has progressed, antibiotic regimensespecially drugs like doxycyclineare generally successful in resolving problems.
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What Are The Neurological Symptoms Of Lyme Disease
In some cases, the neurological symptoms of Lyme disease can be specific in nature. However, other times they are subtle to the point of being insufficient for a Lyme diagnosis. Those with the condition can end up experiencing symptoms of cognitive decline, such as difficulty concentrating or the inability to process information at the rate they did prior to the tick bite. Memory can also be affected by Lyme disease, and can lead to confusion. People may also experience an increased sensitivity to light and changes in their vision.
Because of the way Lyme disease affects cranial nerves and other parts of the brain, other neurological symptoms may appear. The cranial nerve thats affected will determine the type of symptom that occurs. For example, if the facial nerve is affected, a person may experience facial weakness or paralysis. Other nerves being affected can lead to symptoms such as dizziness, balance issues, loss of coordination, and a loss of taste or smell. In more severe cases, people can develop conditions that cause inflammation of the area where the brain and spinal cord meet, leading to meningitis or encephalopathy.
Which Areas Are More Likely To Have It
The tick that causes Lyme disease has been moving from the Northeast and upper Midwest into the Southern and Western U.S., Mexico, and Canada. Cases in California and Florida are on the rise. After a drop between 2017 and 2018, the numbers jumped a little bit in 2019.
But most Lyme cases in 2019 were in 15 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New
Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin. Washington, DC, is also a hotspot.
In 2019, Pennsylvania had the most Lyme infections, with 6,763. New York was next, with 2,847 cases.
In the Southern U.S., where itâs hotter, ticks stay under leaves so they don’t dry out. This means people donât get Lyme from Southern ticks very often because they don’t usually come out to bite.
Even though people only report about 30,000 cases of Lyme infection in the U.S. each year, there are actually around 476,000 a year. The same tick also can spread other diseases, including babesiosis, anaplasmosis, and Powassan virus. Those diseases are also on the rise in the U.S.
Whoâs likeliest to get Lyme disease?
Boys up to age 15 and men between the ages of 40 and 60 are the most likely to get Lyme disease. Thatâs because they tend to play outside and go camping, hunting, and hiking.
Why are there more ticks now than there used to be?
There are several reasons why Lyme is spreading. Some of these are:
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Symptoms Of Late Stage Lyme Disease
The CDC reports that late stage Lyme disease may appear days to months after the initial tick bite and may include but are not limited to:
- Severe headaches and neck stiffness
- Additional EM rashes in new places on the body
- Facial palsy, also known as Bells palsy paralysis of one side of the face
- Arthritis or joint pain and swelling, especially of large joints
- Intermittent tendon, muscle, joint, nerve, or bone pain
- Heart palpitations or arrhythmia
- Dizziness or shortness of breath
- Inflammation of the brain or spinal cord
- Shooting pains, numbness, or tingling in the hands or feet
As mentioned above, late stage Lyme may also be characterized by the recurrence of early stage symptoms, such as fatigue.
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Planning For The Future
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Lyme Disease Triggers Vertigo And Hearing Loss
Vertigo and hearing loss have been reported in several studies as symptoms of Lyme disease. One study found 4 out of 27 patients with neurologic Lyme disease experienced hearing loss.¹ Vertigo was reported in 5 out of 8 Lyme disease patients by Selmani et al.² Additionally, investigators suggest that vertigo can be the predominant symptom in patients with confirmed Lyme disease — its symptoms resembling neuronitis vestibularis in the acute stage.³
A recently published study by Sowula and colleagues provides further evidence that Lyme disease can trigger vertigo and hearing loss. In their article Vertigo as one of the symptoms of Lyme disease, the authors examine the frequency of vertigo symptoms and potential labyrinth damage in patients with diagnosed Lyme disease.4
The study included 38 patients with Lyme disease, who were hospitalized at University Hospital in Krakow, Poland, between 2018 and 2019, due to vertigo or dizziness.
One alleged group of diseases which can trigger vertigo involves infectious diseases of the nervous system, the authors explain.
Many pathogens are said to be in part responsible for inflammation among them are spirochetes of Borrelia as well as other pathogens transmitted by ticks.
The study found:
Increasingly, tick-borne illnesses are a potential cause of neurological symptoms reported by patients, including hearing loss, tinnitus, ataxia and vertigo.
The authors conclude:
What Are The Main Symptoms Of Lyme Disease
Lyme disease can cause a myriad of different symptoms. Initially, the condition can feel like the flu as it is accompanied by symptoms such as body and muscle aches, fatigue, fever, and headaches. A signature sign that someone has contracted Lyme disease is the rash that occurs at the site where the tick latched on. The rash is red and looks much like a bulls eye symbol.
Some other symptoms that can arise in an early case of Lyme disease include chills and swollen lymph nodes. These signs should not be ignored because, as mentioned above, getting prompt treatment will make all the difference in how the disease progresses throughout the body. For those who deem the symptoms too mild to get a proper diagnosis, the bacteria can cause permanent damage until treatment is sought.
Image by on Untreated Lyme disease can lead to confusion and other cognitive issues.
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Symptoms Of Early Stage Lyme Disease
According to the Centers for Disease Control and Prevention , early-stage Lyme disease symptoms crop up within 3 to 30 days after exposure and can include but are not limited to:
- Joint pain and swelling
- Swelling of the lymph nodes
- Erythema migrans , a bulls-eye-shaped rash that appears at the site of the tick bite
Early Lyme disease does not always appear the same in all patients. For example, up to 30% of patients dont remember experiencing a bulls eye rash.
Learn The Stages Of Lyme Disease
Lyme disease occurs in three stages: early localized, early disseminated and late disseminated. However the stages can overlap and not all patients go through all three. A bulls-eye rash is usually considered one of the first signs of infection, but many people develop a different kind of rash or none at all. In most cases, Lyme symptoms can start with a flu-like illness. If untreated, the symptoms can continue to worsen and turn into a long-lived debilitating illness.
Stage 1: Early Localized Disease
Symptoms with early localized Lyme disease may begin hours, a few days or even weeks after a tick bite. At this point, the
infection has not yet spread throughout the body. Lyme is the easiest to cure at this stage.
Symptoms may include:
- skin rash, which may or may not look like a bulls eye
- flu-like illness, including chills and fever
- muscle soreness and joint pain
- swollen lymph nodes
- sore throat
Stage 2: Early Disseminated Lyme
Early disseminated Lyme may occur several weeks or months after the tick bite. Bacteria are beginning to spread throughout the body. In addition to flu-like symptoms, this stage is often characterized by increase in symptoms such as:
- pain, weakness or numbness in the arms, legs
- vision changes
- heart problems, such as palpitations, chest pain
- rash may appear on body
- facial paralysis
Stage 3: Late Disseminated Lyme Disease
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Late Lyme Disease Symptoms
Vertigo And Severe Balance Instability As Symptoms Of Lyme Diseaseliterature Review And Case Report
- 1Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
- 2Nofer Institute of Occupational Medicine, Balance Disorders Unit, Department of Audiology and Phoniatrics, Lodz, Poland
- 3Department of Infectious Diseases and Hepatology, Medical University of Lodz, Lodz, Poland
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Lyme Disease Rashes And Look
Circular, expanding rash with target-like appearance.
Expanding rash with central crust
Expanding lesion with central crust on chest.
Expanding erythema migrans
Photo Credit: Reprinted from Bhate C, Schwartz RA. Lyme disease: Part I. Advances and perspectivesexternal icon. J Am Acad Dermatol 2011 64:619-36, with permission from Elsevier.
Description:Early, expanding erythema migrans with nodule.
Multiple rashes, disseminated infection
Early disseminated Lyme disease multiple lesions with dusky centers.
Red, oval plaque
Red, expanding oval-shaped plaque on trunk.
Expanding rash with central clearing
Circular, expanding rash with central clearing.
Bluish hued rash, no central clearing
Bluish hued without central clearing.
Expanding lesion, no central clearing
Expanding lesion without central clearing on back of knee.
Red-blue lesion with central clearing
Red-blue lesion with some central clearing on back of knee.
Insect bite hyper-sensitivity
Large itchy rash caused by an allergic reaction to an insect bite.
Fixed drug reaction
Description:A skin condition that occurs up to two weeks after a person takes a medication. The skin condition reappears at the same location every time a person takes that particular medication.
Description:Ringworm is a common skin infection that is caused by a fungus. Its called ringworm because it can cause a ring-shaped rash that is usually red and itchy with raised edges.
Pityriasis rosea rash
Granuloma annulare rash