Peripheral Neuropathy In Lyme Disease Patients
Reported cases of Lyme disease have been rising steadily over the past 30 years, but its diagnosis can be challenging. Left untreated, patients with Lyme disease can go on to develop neurological symptoms, including those that are characteristic of peripheral neuropathy.
Francis Bean, DPM, has been experiencing neurological symptoms in his lower extremities for more than six months. When they arise, he feels a tingling in his hallux, his heels go numb, and he develops a hypersensitivity to temperature and touch that leads to a painful burning sensation. On paper, these sound like common symptoms of diabetic peripheral neuropathya condition with which Bean, as a podiatrist, is quite familiar.
But Bean doesnt have diabetes. His peripheral neuropathy developed as a result of Lyme disease, and in the US, hes one of a growing number of people with similar complications.
Lyme borreliosis, or Lyme disease, is a multisystem infectious disease caused in the US by the spirochete Borrelia burgdorferi , which is transmitted almost exclusively through tick bites.1,2 Though cases are concentrated primarily in limited geographic areas where the tick is endemic, Lyme disease is the most commonly reported vector-borne infection in the country, and reported cases of its occurrence have been rising steadily over the past 30 years.3,4
Neck Pain From Lyme Disease
Lyme disease is commonly associated with tick bites and a big circular rash. However, a tick bite does not hurt and many people do not recall being bit or seeing the rash. Further complicating matters, Lyme disease symptoms may start out minor and not become problematic for months or longer.
Lyme disease causes neck pain in more than 30% of cases. Watch:Neck Pain Causes Video
Media reports rarely focus on neck pain with Lyme disease, but some estimates note that it occurs in more than 30% of the cases and is typically one of the earlier symptoms.1 Recognizing Lyme disease early and seeking treatment can make a big difference in the outcome.
Lyme Sci: Nerve Damage Shown In Patients With Chronic Lyme Symptoms
Many Lyme disease patients report severe chronic pain, numbness and tingling, even after they have supposedly completed treatment for Lyme disease.
But up until recently, there hasnt been an objective way to measure those symptoms. You had to report them to the doctor, hoping hed take you at your word about what you were feeling.
New research suggests such sensations may be caused by nerve damage. Additional findings show that decreased blood flow in the brain may also be contributing to dysautonomia. Thats dysfunction of the system that regulates bodily functions such as blood pressure, digestion, and sweating.
Now, a groundbreaking study provides quantifiable, physiological reasons for these chronic symptoms that continue to plague a subset of patients despite treatment for Lyme disease.
Recommended Reading: When Should You Get Tested For Lyme Disease
Can Neuropathy Be Reversed
If the underlying cause of the neuropathy can be treated and cured , its possible that the neuropathy can be reversed too. However, frequently by the time individuals are diagnosed with a neuropathy, there is some degree of permanent damage that can’t be fixed.
Even though this is the general belief of today, its not the hope of tomorrow. Nerve damage may be reversible someday. Researchers are already seeing positive results the regrowth of nerve fibers in a drug study in mice with diabetes. Ongoing research combined with living a healthy lifestyle so the body can repair itself will likely be needed. Stay tuned.
What Are The Symptoms Of Neuropathy
Symptoms of neuropathy vary depending on the type and location of the nerves involved. Symptoms can appear suddenly, which is called acute neuropathy, or develop slowly over time, called chronic neuropathy.
Common signs and symptoms of neuropathy include:
- Tingling or numbness, especially in the hands and feet. Sensations can spread to the arms and legs.
- Sharp, burning, throbbing, stabbing or electric-like pain.
- Changes in sensation. Severe pain, especially at night. Inability to feel pain, pressure, temperature or touch. Extreme sensitivity to touch.
- Falling, loss of coordination.
- Not being able to feel things in your feet and hands feeling like youre wearing socks or gloves when youre not.
- Muscle weakness, difficulty walking or moving your arms or legs.
- Weight loss .
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Stop Rx Meds That Cause Neuropathy
There are a number of medications that can cause neuropathy. You should review your list of medications with your physician or health care provider. There are three classes of anti-microbials used in Lyme treatments that can lead to neuropathy.
- azoles including fluconazole , metronidazole, tinidazole, and itraconazole
Can Neuropathy Be Prevented
You can reduce your risk of neuropathy by treating existing medical problems and adopting healthy living habits. Here are some tips:
- Manage your diabetes: If you have diabetes, keep your blood glucose level within the range recommended by your doctor.
- Take care of your feet: If you have diabetes or poor blood flow, its important to check your feet every day. Look for sores, blisters, redness, calluses, or dry or cracking skin. Keep your toenails clipped apply lotion to clean, dry feet and wear closed-toe, well-fitting shoes. Protect your feet from heat and cold. Dont walk barefoot.
- Keep your floors free of items that could cause you to trip and fall. Make sure all electrical cords are tucked away along the baseboards of walls and rooms are well lit.
- Stop smoking: Smoking constricts blood vessels that supply nutrients to nerves. Without proper nutrition, neuropathy symptoms can worsen.
- Maintain a healthy lifestyle:Eat a balanced diet, stay within your ideal weight range, exercise several times a week and keep alcoholic drinks to a minimum. These healthy living tips keep your muscles strong and supply your nerves with the oxygen and nutrients they need to remain healthy.
- Review your medications: Talk with your doctor or pharmacist about all the medications and over-the-counter products you take. Ask if any are known to cause or worsen neuropathy. If so, ask if a different medication can be tried.
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What Is Multiple Sclerosis
MS is a nervous system condition caused by immune system dysfunction. It affects your central nervous system. If you have MS, your immune system attacks the protective layer that covers nerve fibers, known as myelin. This causes problems in impulse transmission between your brain and spinal cord and the rest of your body, resulting in a range of symptoms.
MS is more commonly diagnosed in young adults and in those prior to middle age. Almost 1,000,000 people in the United States have it. It can range from mild to severe and is a lifelong condition.
Symptoms of MS can come and go but generally become more present with time. The exact causes of MS are unknown. Immunologic, environmental, infectious, and genetic factors are all suspected to contribute to this autoimmune condition.
Can Neuropathy Be Stopped
Your long-term outcome depends on what is causing your neuropathy. If your neuropathy is caused by a treatable condition, managing the condition might result in stopping the neuropathy or preventing it from getting worse. If the underlying cause of the neuropathy cant be treated, then the goal is to manage the symptoms of neuropathy and improve your quality of life.
Neuropathy rarely leads to death if the cause is determined and controlled. The sooner the diagnosis is made and treatment is started, the greater the chance that nerve damage can be slowed or repaired. Recovery, if its possible, usually takes a very long time — from months to even years. Some people live with a degree of neuropathy for the rest of their lives.
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Neurological Symptoms From Late
If Lyme disease or associated infections are not adequately treated or go untreated, the persistence of the bacteria, and the inflammation from the immune response, can affect nerve function leading to a myriad of neurological symptoms. One study indicated it took an average of a year and a half following a tick bite for symptoms to manifest in the peripheral nervous system and two years to the onset of symptoms in the central nervous system . The significant length of time from bacterial exposure to onset of symptoms creates a challenge in associating Lyme disease as the cause of chronic neurological symptoms.
Neuropathy is a general term for disease of the nerves.
Polyneuropathy refers to multiple nerves involved in the pathology. In late-stage Lyme disease, polyneuropathy typically manifests as numbness, tingling or burning and can include any nerve but most commonly begins in the hands/arms and feet/legs. Less frequently, chronic neuropathy can lead to radicular pain.
Encephalopathy refers to generalized brain dysfunction
How Common Is Neuropathy Who Gets Neuropathy
Neuropathy is very common. It is estimated that about 25% to 30% of Americans will be affected by neuropathy. The condition affects people of all ages however, older people are at increased risk. About 8% of adults over 65 years of age report some degree of neuropathy. Other than age, in the United States some of the more common risk factors for neuropathy include diabetes, metabolic syndrome , and heavy alcohol use. People in certain professions, such as those that require repetitive motions, have a greater chance of developing mononeuropathies from trauma or compression of nerves.
Among other commonly cited statistics, neuropathy is present in:
- 60% to 70% of people with diabetes.
- 30% to 40% of people who receive chemotherapy to treat cancer.
- 30% of people who have human immunodeficiency virus .
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What Types Of Peripheral Nerves Are There And What Do They Do
The peripheral nervous system is made up of three types of nerves, each with an important role in keeping your body healthy and functioning properly.
- Sensory nerves carry messages from your five senses through your spinal cord to your brain. For example, a sensory nerve would communicate to your brain information about objects you hold in your hand, like pain, temperature, and texture.
- Motor nerves travel in the opposite direction of sensory nerves. They carry messages from your brain to your muscles. They tell your muscles how and when to contract to produce movement. For example, to move your hand away from something hot.
- Autonomic nerves are responsible for body functions that occur outside of your direct control, such as breathing, digestion, heart rate, blood pressure, sweating, bladder control and sexual arousal. The autonomic nerves are constantly monitoring and responding to external stresses and bodily needs. For instance, when you exercise, your body temperatures increases. The autonomic nervous system triggers sweating to prevent your body’s temperature from rising too high.
The type of symptoms you feel depend on the type of nerve that is damaged.
Key Points For Healthcare Providers
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How Quickly Does Neuropathy Develop
Some peripheral neuropathies develop slowly over months to years while others develop more rapidly and continue to get worse. There are over 100 types of neuropathies and each type can develop differently. The way your condition progresses and how quickly your symptoms start can vary greatly depending on the type of nerve or nerves damaged, and the underlying cause of the condition.
There are many causes of neuropathy. Diabetes is the number one cause in the United States. Other common causes include trauma, chemotherapy, alcoholism and autoimmune diseases.
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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Whats The Difference Between Neurologic Lyme Disease And Ms
Olga Syritsyna, MD
Hearing the words you have Lyme disease or you have MS can be quite unsettling. And to complicate matters, when Lyme disease affects the central nervous system, the symptoms can be very similar to MS. So it can be hard to tell the difference to the untrained eye. Many doctors are generalists and not specially trained to diagnose either disease. Dr. Olga Syritsyna is a neurologist with subspecialty training in neurologic Lyme disease and MS.
What is neurologic Lyme disease?First, lets start with defining Lyme disease. Its a seasonal tick-borne infection caused by the borrelia burgdorferi bacteria that can affect multiple organs and systems in the body. Its named after Lyme, CT, where it was first identified in 1975. In about 15 percent of cases, Lyme disease affects the central nervous system. When it does, it is known as neurologic Lyme disease. Sometimes, people who think they may have Lyme disease find out they have MS . Lyme disease as an infection can act to trigger MS attacks. This is why being seen by a neurologist specially trained to know the differences is key.
Why choose Stony Brook for diagnosis and treatment of neurologic Lyme disease?For neurologic Lyme disease, Stony Brook has extensive experience in detecting antibodies to the borrelia burgdorferi bacteria that is carried by ticks and can affect the central nervous system. We do frequent lumbar punctures and perform a variety of tests on cerebrospinal fluid.
Causes Of Pins And Needles : Preventing & Treatment
- Post author Scientific review: Dr Heben’s Team
Have you ever felt the pins and needles sensation? We bet that every one of you has already experienced it in your lifetime. Generally, pins and needles is a common condition and often nothing to be concerned about since its just a sign from your nerves that telling you that your specific part of the body need more oxygen supply. So, it is a normal thing if youre having pins and needles sensation when youre having a bad position during the sleep, or sitting down too long in a chair, or youre crossing your leg in a long time.
Since this symptom is commonly harmless to your body, but you need to give this symptom a special attention if youre experiencing it over-frequently, with the addition with other hazardous symptoms related to your nerves, brain, and other thing that already explained in this article, because it could be the early sign that youre suffering from various chronic diseases as already listed below.
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Repair Nerve Cell And Mitochondria Outer Membrane Damage*
In neuropathy often the outer membrane of the nerve cell is damaged. This membrane is composed of phospholipid fats called phosphatidylcholine and phosphatidylserine.
Sometimes the energy factories found in nerve cells called mitochondria also get injured. When the mitochondria are injured, nerves cannot generate enough energy to repair. In mitochondrial injury the outer membrane of the mitochondria is damaged. This membrane too is composed of phosphatidylcholine and phosphatidylserine.
There are three products I suggest that include mitochondria membrane fats. These products are all manufactured by Researched Nutritionals. These products are NT Factor Energy, ATP Fuel, and ATP 360. Each of these products contains types of fats shown to repair and support the mitochondria membranes. They also include various micronutrients that support mitochondria function.
NT Factor Energy and ATP Fuel include a proprietary blend of phosphatidylserine and phosphatidylcholine made by another company called NT Factor. In studies with people reporting fatigue, NT Factor in both of these products is shown to improve energy at two months by an average of 40%. ATP Fuel contains CoQ10, but NT Factor Energy does not. CoQ10 should not be used in Babesia treatments that include atovaqone because it interferes with their ability to kill this germ.
NT Factor Energy is the only product to take if a person is on atovaqone found in Mepron and Malarone to treat babesia.
Treatment Of Acute Neuroborreliosis
In acute Lyme neuroborreliosis, treatment needs to be directed at the bacterial infection. Administering the antibiotic ceftriaxone intravenously for 14 days has proven to be effective at treating the bacteria in the central nervous system. Blood levels of oral antibiotics or herbal formulas may not reach high enough concentrations to treat central nervous system infections effectively.
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Can Neuropathy Lead To Amputation
Yes, neuropathy especially diabetes-related neuropathy can lead to limb amputation. Each year about 86,000 Americans with diabetes lose a limb. The sequence of events leading up to amputation is typically this: the high glucose levels seen in diabetes cause nerve damage. The nerve damage reduces sensation in the limbs , which can lead to unnoticed injuries turning into skin ulcers or infections. Reduced blood flow to the feet, another effect of diabetes, prevents the wound from healing properly. The wounds cause the tissue in the foot or leg to break down, requiring amputation.
You can, however, reduce your chance of an amputation by keeping your diabetes under control and carefully caring for your skin and feet.