Routine Laboratory Parameters In Blood
In the routine laboratory, patients with Lyme neuroborreliosis have normal or slightly elevated values for ESR, CRP, leukocytes and transaminases that indicate a systemic infection ). When diagnosing Lyme neuroborreliosis, the routine laboratory results only play a role in differential diagnosis.
Routine lab parameters for patients with early or late manifestations of Lyme neuroborreliosis
Visualizing Brain Fog In Post
More than one in 10 people successfully treated with antibiotics for Lyme disease go on to develop chronic, sometimes debilitating and poorly understood symptoms of fatigue and brain fog that may last for years after their initial infection has cleared up.
Now, a Johns Hopkins team has used an advanced form of brain scan to show that 12 people with documented post-treatment Lyme disease syndrome all show elevation of a chemical marker of widespread brain inflammation, compared with 19 healthy controls.
Results of the study, published in Journal of Neuroinflammation, suggest new avenues for treating the long-term fatigue, pain, sleep disruption and brain fog associated with PTLDS. Theres been literature suggesting that patients with PTLDS have some chronic inflammation somewhere, but until now we werent able to safely probe the brain itself to verify it, says Jennifer Coughlin, a senior author and associate professor of psychiatry and behavioral sciences.
What this study does is provide evidence that the brain fog in patients with post-treatment Lyme disease syndrome has a physiological basis and isnt just psychosomatic or related to depression or anxiety, says John Aucott, director of the Johns Hopkins Lyme Disease Research Center.
In addition, the results suggest that drugs designed to curb neuroinflammation may be able to treat PTLDS, although clinical trials are needed first to determine the safety and benefit of such therapy, Aucott says.
Neurological Manifestations In Adults
Garin-Bujadoux-Bannwarth syndrome is the most common manifestation of acute Lyme borreliosis in adults in Europe after erythema migrans , , .
In Europe, isolated meningitis is mainly observed in children , , , , .
The symptoms of radiculitis develop on average 46 weeks after the tick bite or after the erythema migrans , . Segmental pain occurs first, which intensifies at night and whose localisation can change. Often the pain is initially localised in the extremity where the tick bite or erythema migrans was first observed , . The patient experiences pain that is burning, nagging, stabbing or tearing in nature and responds only slightly to conventional analgesics. It often peaks within a few hours or days. Three-quarters of patients develop neurological deficits after 14 weeks, and pareses are more frequent than sensory disorders , .
About 60% of patients with Bannwarths syndrome have cranial nerve deficits.
Involvement of the central nervous system is rare and occurs in only around 4% of Lyme neuroborreliosis cases , . Its onset is gradual and it is frequently chronic. The most common manifestation is myelitis with spastic atactic gait disturbance and bladder dysfunction , . Symptoms can develop over days or several months. Some patients suffer from severe tetra- or paraparesis. Approximately 60% of patients with myelitis have additional signs of encephalitis and around 40% have cranial nerve involvement. Encephalitis has no clinical properties specific to the pathogen.
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Find The Right Doctor
To treat brain fog, the doctor you see will make a difference in how you heal. A Lyme literate doctor is a specialist in Lyme disease, including brain fog and eliminating it.
Lyme literate doctors provide treatments in their clinic daily. Dont seek the closest or least expensive doctor. Instead, seek the most qualified, even if you have to go outside the U.S.
You deserve help in reducing inflammation that can eliminate brain fog. Reach out for help today.
Objectives Of This Guideline
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Definition of the disease
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Confirmation of a clinical diagnosis
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Differentiation of non-specific complaints
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Cerebrospinal fluid testing including antibody detection in CSF
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Meaningful use of molecular-diagnostic testing and culture tests
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Therapy
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Observation of the skin area around the tick bite information sheet for patients
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Diseases caused by relapsing fever Borrelia are not covered in this guideline
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Questions relating to co-infections linked to diseases transmitted by ticks are not covered in this guideline
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Acute Vs Chronic Lymedisease
There are some importantdifferences between acute and chronic Lyme disease. When infection occurs andthe bacteria enter the body, the immune system recognizes the microbes asharmful and begins fighting them. If the immune system is strong and robust,the initial symptoms may be very mild, and sometimes there wont be anysymptoms at all. This is why people often dont even realize theyve beeninfected.
In its early stages, Lymedisease is usually treated successfully with antibiotics. But if the infectionremains undiagnosed, the bacteria can go on living inside the cells withoutcausing any trouble for a long time. As they travel to other tissues andorgans, including the brain, they eventually disperse throughout the body. Theonly time symptoms might present is when the immune system weakens due toillness, extreme stress, or some other reason. This is when the bacteria startto flourish, causing a chronic infection.
Chronic Lyme disease occurswhen the entire microbiome is disrupted. After this has happened, the immune system continues todysfunction, which can lead to many different types of symptoms. This chronicphase can even last a lifetime.
What Is Late Lyme Disease
Lyme disease, also known as Lyme borreliosis, is caused by an infection with the bacteria Borrelia burgdorferi. This bacteria is disseminated through tick bites. Infected ticks usually bite small mammals, who do not develop any kind of infection from the bacteria. When humans are exposed to B. Burgdorferi from a tick bite, however, they can develop Lyme disease.
People who work outside or spend time in woodland areas, where there is greater potential for exposure to tick bites, are most at risk of infection.
Lyme disease is a condition which progresses in stages:
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Lyme Sci: When Brain Inflammation Persists After Lyme Disease Treatment
In a new study, researchers from the Johns Hopkins School of Medicine have found evidence of chemical changes and widespread inflammation in the brains of patients with chronic symptoms following treatment for Lyme disease.
This Johns Hopkins study, in Journal of Neuroinflammation, supports the experience of hundreds of thousands of patients who have tried for years to have their chronic symptoms of pain, sleep disturbance, fatigue, and cognitive impairment validated.
What this study does is provide evidence that the brain fog in patients with post-treatment Lyme disease syndrome has a physiological basis and isnt just psychosomatic or related to depression or anxiety, says John Aucott, M.D., a senior author of the new paper and director of the Johns Hopkins Lyme Disease Research Center.
The fact is, too many patients with Lyme disease are left with chronic, debilitating symptoms following treatment for Lyme disease. In the nearly 40 years since the discovery of Lyme, no one has been able to determine why some patients get better with treatment and others remain ill.
Cause #: Untreated Infections
Lyme disease and Lyme coinfections like babesia, bartonella, and mycoplasmacontribute to metabolic and immune changes in the body because the microbes can be low-grade and persist for long periods of time. While no system of the body is off-limits, the central nervous system and the endocrine system are particularly vulnerable.
When pathogens invade the nervous system, white blood cells immune cells like lymphocytes and plasmocytes flood into the white matter of the brain and the spinal cord, says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan. This causes a cascade of inflammatory immune messengers, called cytokines, in cerebrospinal fluid.
This influx of proinflammatory cytokines causes neuroinflammation in the brain, which can contribute to a range of neurological symptoms, including those associated with Lyme brain. Because most Lyme patients have a compromised immune system, the body struggles to keep the offending pathogens in check.
The outcome? You continue to experience a prolonged inflammatory response and resulting symptoms until youre able to suppress the harmful, stealth infections.
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Infectious Diseases And Mental Health
Lyme disease and TBRF are not the only infectious disease to have ties to mental illness. One of the earliest and most well-known examples of an infectious disease that causes neurological and psychiatric symptoms is syphilis.
This sexually transmitted disease, which like Lyme is caused by a spiral-shaped bacteria and treated at early stages with antibiotics, has been called the great imitator also like Lyme because its symptoms can be wide-ranging and non-specific, especially at late stages. That includes neurological and psychiatric symptoms that become much more likely the longer the disease goes untreated.
Given that ties between late-stage syphilis and mental illness have long been recognized by the medical community, it shouldnt be surprising that untreated Lyme disease poses similar risks to patients psychological wellbeing. Recent studies have investigated possible connections between Lyme disease and a host of mental health issues, including:
- Developmental disorders
- Seizures
- Suicide
Yet there are still many doctors and scientists who doubt the existence of chronic Lyme disease, and/or do not realize how many different borrelia cause TBRF, hurting patients chances of fighting both the diseases themselves and their mental health consequences.
The 3 Obstacles To Neurological Lyme Disease Treatment
Chronic Lyme disease is often associated with neurological symptoms that are both debilitating and increasingly difficult to treat. At Envita we understand Lyme disease better than anyone and we are familiar with the struggle patients experiencing neurological Lyme symptoms face. There are three major areas of conflict that patients with neurological Lyme symptoms battle.
Envita Medical Centers doesn’t make any guarantee of outcomes. Results are not typical and will vary from person to person and should not be expected.
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Insights On Neurological Lyme Disease
She rounds out her discussion of these issues by interviewing five professionals who know a lot about neurological Lyme disease. One is psychiatrist Robert Bransfield, MD, a top expert on how Lyme affects the brain . Another is Sandra Berenbaum, LCSW, with whom I co-authored the book When Your Child Has Lyme Disease: A Parents Survival Guide. Others are Leo Shea, Ph.D., who has extensive experience with neuropsychological testing of children and adults with Lyme disease health advocate/blogger Scott Forsgren, founder of BetterHealthGuy.com, who writes extensively on Lyme-related issues and Connie Strasheim, author of many books about Lyme disease. They all offer useful insights on the topic of Lyme disease brain.
Throughout the book, Ducharme offers practical information with a strong helping of optimism. As she writes early on:
I find that the majority of people with Lyme brain can find resolution or, at the very least, significant improvement of their symptoms.Im not saying its quick or easy, but I have seen remarkable improvements in people who started out very, very ill with horrible Lyme brain and are now back at work, running their families and living their lives as productive, happy people.
If you or a loved one has a problem with neurological Lyme disease symptoms, I think youll find this book both helpful and hopeful.
What Is Neurologic Lyme Disease
Neurologic symptoms of Lyme disease occur when the Lyme disease bacteria affect the peripheral or central nervous systems.
- Cranial nerve involvement: When the cranial nerves are affected, facial palsy can occur on one or both sides of the face.
- Peripheral nerve involvement: When the peripheral nerves are affected, patients can develop radiculoneuropathy which can cause numbness, tingling, shooting pain, or weakness in the arms or legs.
- Central nervous system involvement: When the central nervous system is affected, Lyme meningitis can cause fever, headache, sensitivity to light, and stiff neck.
Out of every 100 patients whose cases are reported to CDC, 9 have facial palsy, 4 have radiculopathy, and 3 have meningitis or encephalitis. Because of reporting practices, this statistic may overestimate how often these manifestations are seen by clinicians.
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Controversy: Split Over Treatment For Persistent Symptoms
Medical groups continue to disagree about the optimal approach if a patients symptoms persist after the initial antibiotic treatment. A recent Lyme disease overview summarizes the differing guidelines .
- When patients have persistent or recurrent symptoms following recommended antibiotic treatment but no evidence of reinfection, further treatment is not recommended .
- While other potential causes for persistent symptoms should be investigated first, additional antibiotics are recommended if a chronic Lyme infection is believed to be a possible cause for ongoing symptoms and the patient has an impaired quality of life .
Lyme Disease Effects On The Brain
The first section of Lyme Brain discusses the fundamentals. What actually causes this condition? Research has shown that Lyme spirochetes can invade the brain and wreak all kinds of havoc. They damage nerve cells, trigger inflammation, release neurotoxins, and disrupt the balance of brain chemicals.
Ducharme lays all this out in plain language. She also explains how co-infections contribute to Lyme disease brain:
One of the reasons I believe that the actual brain fog, memory issues and difficulty with focus and concentration is Borrelia driven is because when I treat my patients with medications that primarily impact Borrelia and cross the blood-brain barrier, I see these symptoms improve, whereas the insomnia and wacky dreams tend to respond more to Babesia treatment. Really extreme psychiatric symptoms such as rages, and suicidal thoughts and behaviors, respond mostly to Bartonella treatment.
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Treating Lyme Neuroborreliosis In Children
Recommendations for treating children and adults
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Antibiotic treatment should be carried out in the case of Lyme neuroborreliosis with inflammatory cerebrospinal fluid syndrome .
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In the case of a possible Lyme neuroborreliosis , antibiotic treatment may be considered after a thorough differential diagnosis and if there is no evidence of another disease.
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Antibiotic treatment should take place over a period of 14 days or 1421 days .
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Reference is made to the S2k Guideline Cutaneous Lyme Borreliosis for the treatment of polyneuropathy associated with acrodermatitis chronica atrophicans .
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If a distally symmetrical polyneuropathy is suspected as a manifestation of Lyme neuroborreliosis without accompanying ACA , the same procedure recommended for possible Lyme neuroborreliosis can be used.
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Cerebral vasculitis resulting from Lyme borreliosis should be treated with antibiotics in accordance with the recommendations for late Lyme neuroborreliosis.
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Analogous to the recommendations for cerebral vasculitis of another aetiology , the additional administration of steroids and/or 100 mg/d of ASS can be considered for cerebral vasculitis resulting from Lyme borreliosis.
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In addition to antibiotic treatment, symptoms should also be treated .
Recommendation for choosing antibiotics for children and adults
Recommendations for monitoring the treatment of children and adults
Why Choose Hope Brain & Body Recovery Center For Treatment
When seeking treatment for neurological conditions, you shouldnt settle for anything but the most premium treatment. Dr. Joseph Schneider has over 30 years of clinical experience and has attended to over 11,000 patients with a wide array of neurological conditions.
Dr. Schneider has firsthand experience with neurological treatment, having suffered a stroke in 2017. Thanks to his incredibly talented associates and personal knowledge of treatment methods, has made a miraculous recovery. He has devoted his life to the neurological health of his patients and uses his firsthand experience of the recovery process to improve the treatment methods used at Hope Brain & Body Recovery Center.
Choosing Hope Brain & Body Recovery Center gives you access to some of the most modern technical treatment equipment available. We utilize a wide range of modern diagnostic equipment that helps our specialists build some of the most comprehensive neurological profiles for our patients. This means we are able to offer more accurate diagnoses, discover underlying conditions, as well as use the information to create therapy plans that are uniquely designed for each patient.
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The Case Study Pathology Is Characteristic Of Dementia With Lewy Bodies
The fresh brain weighed 996 g and appeared atrophic Coronal sections through the left cerebral hemisphere and brain stem revealed mild enlargement of the lateral ventricle, particularly the temporal horn. The substantia nigra was normally pigmented or nearly so. Microscopically, nigral and cortical Lewy bodies, were seen with hematoxylin and eosin stain . Immunohistochemistry for -synuclein showed numerous immunoreactive Lewy bodies and fibers in substantia nigra, hippocampal formation and neocortex, Figures 4CE). IHC for hyperphosphorylated tau revealed intense staining of many limbic neurofibrillary tangles and neuropil threads , and of occasional neurofibrillary tangles in neocortex, but senile plaques were extremely rare, and each contained only a few fibrils . H& E showed prominent thickening of small blood vessels in gray and white matter, extensive mineralization of pallidal vessels, and rare microglial nodules in the hippocampal formation. Immunohistochemistry for Iba-1 , CD68 , and CD163 showed moderate numbers of activated microglia and large numbers of macrophages in hippocampal formation and spinal cord . In summary, we see DLB accompanied by features of Alzheimer’s disease, a common presentation.