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.
Defining Patient Subgroups: Post
Patients with persistent symptoms related to Lyme disease likely represent a heterogeneous population, which includes previously untreated patients, as well as those treated patients who remain symptomatic. As a result, some will manifest primarily patient-reported symptoms while others will present with symptoms in conjunction with objective, physical findings. This heterogeneity is further complicated by variation in terminology and the definitions used by different groups in the field.
Figure 3. A schematic of clinical- and research-defined patient subgroups among those with persistent symptoms associated with Lyme disease . The size of each patient subgroup is not meant to represent actual population frequency, as prevalence data is extremely limited. IDSA, Infectious Diseases Society of America ILADS, International Lyme and Associated Diseases Society CLD-PT, Chronic Lyme Disease-Previously Treated CLD-U, Chronic Lyme Disease-Untreated IgG, Immunoglobulin G CFS, Chronic Fatigue Syndrome FM, Fibromyalgia.
What Is The Outlook For Someone With Lyme Disease
Most of the people who get Lyme disease and receive treatment early will be fine. Treatment can cure Lyme disease but you might still have some long-term effects. Untreated Lyme disease may contribute to other serious problems but its rarely fatal.
Post-treatment Lyme disease syndrome
Even after proper treatment, some people may experience lingering fatigue, achiness or headaches. This is known as post-treatment Lyme disease syndrome or PTLDS. The symptoms dont mean that you still have an infection. PTLDS probably wont respond to additional antibiotics. The majority of people in this group will have symptoms that resolve at some point over the next six months.
Chronic Lyme disease
Chronic Lyme disease is a term used by some for a condition in a person who had Lyme disease and the symptoms of PTLDS. Some people consider chronic Lyme disease to be the same as PTLDS. However, some people receive a chronic Lyme disease diagnosis without a Lyme disease diagnosis. Sometimes, extended treatment with antibiotics helps.
This term may be why some people think a Lyme disease infection can occur without being bitten by a tick. There isn’t enough proof that mosquitoes can transmit Lyme disease. Many researchers dislike using the term chronic Lyme disease.
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Wisconsin’s ‘chronic Lyme’ Patients Embrace Alternative Treatments Rack Up Big Bills
Sufferers say they go down “rabbit holes” to diagnose a condition that many doctors say does not exist.
Shelbie Bertolasi explains the variety of supplements she takes to treat her Lyme disease. Bertolasi has spent the past few years treating her symptoms with a variety of supplements, some of which cost anywhere from $30 to $90 a bottle. She estimates she spends about $500 a month on supplements. She is seen at her home in Waukesha on Dec. 1, 2021.
Crystal Pauley, a former physician assistant, didn’t believe in so-called chronic Lyme disease until she became sick.
Early Stage Lyme Disease Neck Pain
Early stage Lyme disease begins to manifest itself within a few days of an infected tick bite. The first symptoms of the disease are called early stage localized expressions, which is really an inaccurate term, since some of these symptoms might become systemic almost immediately. Neck pain might exist due to lymph gland swelling, general inflammation or simply sore muscles that are commonly experienced following initial Lyme exposure. Many victims describe the initial month of symptoms as being similar to a case of influenza, including characteristic stiff and painful neck muscles.
Early stage disseminated symptoms typically occur within days to weeks of initial exposure and will increase the effects of the condition dramatically in untreated patients. Neck symptoms may include idiopathic shooting pains, disturbing neurological sensations, continuing stiffness and muscular discomfort. A selection of patients also report pain in the upper spinal joints, as well as in other large bodily joints. This discomfort ranges from dull and achy to sharp and shocking, typically upon movement.
Some patients are stricken with meningitis, which is a very serious condition involving contamination of the cerebral spinal fluid that surrounds the spine and brain. This can also cause additional pain, stiffness and discomfort in the greater neck anatomy.
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Early Symptoms Of Lyme Disease
More than 30,000 cases of Lyme disease are reported to the Centers for Disease Control each year. The risk of Lyme disease is greatest in the spring and summer when the disease is commonly transmitted through tick bites.
Preventing tick bites is key to fending off an infection, but if you do get bit, look out for these early symptoms of Lyme disease:
What Is Dementia With Lewy Bodies
Dementia is a general term referring to an impaired ability to remember, think or make decisions that interferes with ones ability to perform normal activities of daily living.
Symptoms can vary widely from person to person. People with dementia typically have problems with:
- Reasoning, judgment, and problem solving
- Visual perception beyond typical age-related changes in vision
Lewy body dementia is associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood.
In healthy people, alpha-synuclein plays a number of important roles in neurons in the brain, especially at synapses, where brain cells communicate with each other. In LBD, alpha-synuclein forms into clumps inside neurons, starting in areas of the brain that control aspects of memory and movement. This process causes neurons to work less effectively and, eventually, to die.
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Treatment Following A Tick Bite
- In some circumstances, a single dose of antibiotic given within 72 hours of a tick bite might prevent the development of Lyme disease. Several criteria must be met:
- The tick must be identified as the blacklegged tick .
- The tick must have been attached for at least 36 hours .
- The tick bite occurred in a highly endemic area
Later Symptoms Of Lyme Disease
More serious symptoms may develop if Lyme disease is left untreated or is not treated early. These can include:
- pain and swelling in the joints
- nerve problems such as numbness or pain in your limbs
- memory problems
- difficulty concentrating
Some of these problems will get better slowly with treatment. But they can persist if treatment is started late.
A few people with Lyme disease go on to develop long-term symptoms similar to those of fibromyalgia or chronic fatigue syndrome. This is known as post-infectious Lyme disease. It’s not clear exactly why this happens. It’s likely to be related to overactivity of your immune system rather than continued infection.
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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.
Look Up And Out In Daily Life
Even people without inflammation caused by Lyme may struggle with neck pain, due to our collective lifestyle of staring at the computer and the phone. We look down way, way too much.
When we look down, even just a bit, we straighten out our natural cervical curve. We also tax our shoulder muscles, asking them to hold the weight of our heavy heads.
As I type this, I am looking out the window, not at my screen. I glance down to correct typos, then look back out. It makes me a better typist! Little changes like this affect your cervical health immensely.
Begin to notice the time you spend looking down, and play with it. If you are out walking, are you looking at the sidewalk? Try walking and looking at the clouds. Its interesting how disorienting this can feel. It is good for the brain as well as the neck to mix it up and try something new.
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Who Gets Lyme Disease
Lyme disease can affect people of any age. People who spend time outdoors in activities such as camping, hiking, golfing, or working or playing in grassy and wooded environments are at increased risk of exposure. The chances of being bitten by a deer tick are greater during times of the year when ticks are most active. Ticks can be active any time the temperature is above 45° F. Young deer ticks, called nymphs, are active from mid-May to mid-August and are about the size of poppy seeds. Adult ticks are most active from March to mid-May and from mid-August to November and are about the size of sesame seeds. Both nymphs and adults can spread Lyme disease. Infected deer ticks can be found throughout New York State.
What Is Lyme Disease
Lyme disease is caused by a bacteria, Borrelia burgdorferi, which you can get if an infected deer tick bites you. Ordinary “wood ticks” and “dog ticks” dont carry the infection.
The first recognition of Lyme disease, also called borreliosis, began in 1975 when many children received a diagnosis of juvenile rheumatoid arthritis in Lyme, Connecticut, and two neighboring towns. Researchers found that bites from infected deer ticks were responsible for the outbreak of arthritis.
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Lyme Disease Neck Pain
Lyme disease neck pain describes symptoms in the cervical region that come about due to exposure to the bacteria that causes Lyme infection. Both early and late stage cases of Lyme disease can create expressions in the neck, including stiffness, pain and neurological dysfunction. Lyme disease is a hotly-debated condition and remains controversial in many ways. Positive diagnosis might be difficult to achieve and the disease is often mistakenly identified as another completely separate disorder. Proper treatment is another unclear aspect of the disease, since many cases require no treatment at all, while the majority of presentations respond well to typical antibiotic therapy. In a minority of cases, the disease gets a firm foothold and becomes a chronic treatment-defiant terror that can debilitate patients completely.
This focused essay details the relationship between Lyme disease and neck pain, as well as provides a general overview of some of the lesser known facets of the condition.
Symptoms Of Lyme Disease
For years we referred to Syphilis as the great masquerader, a disease that could disguise itself in many forms. If this disease was not caught in the initial stages of a painless chancre or sore that appeared at the site of entry into the body, it could elude diagnosis from physicians as the infection moved deeper into the body. Now Lyme disease is the new masquerader.
Having many similarities, both Syphilis and Lyme disease are caused by a spiral-shaped, gram negative, highly mobile bacteria, called a spirochete. Syphilis is caused by Treponema pallidum and is believed to have been around since the mid 1400s. Lyme disease came to the stage much later in 1975 in the small town of Lyme, Connecticut, when there were clusters of children diagnosed with Juvenile Rheumatoid Arthritis. In 1981, Willy Bergdorfer identified the causing agent of Lyme disease to be the spirochete, Borrelia burgdorferi. Since that time, many species of Borrelia have been identified, including Borrelia afzeii, Borrelia garinii, Borrelia hemsii, Borellia parkeri, Borrelia miyamotoi and Borrelia recurrentis. At this time we are unsure of the ability of all of these organisms to cause disease in humans or to what extent, but we are learning more each day and realizing these varied species likely attack different parts of the body. As the scope of this information is too broad for this article, I will focus on the many presentations of Lyme disease.
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Current Challenges And Future Priorities
Patients with PTLD represent a substantial burden to the United States health care system. In a large, health insurance claims analysis of 47 million members, estimated total direct medical costs from Lyme disease were between $712 million and $1.3 billion per year, with a significant portion of these specifically due to PTLD-related costs . The same study found that the adjusted odds of any PTLD-related symptom diagnosis following Lyme disease was 4.77 higher than age-, sex-, enrollment year-, region- and payer type-matched controls without Lyme disease, and that those patients with Lyme disease who went on to have at least one PTLD symptom had over twice the average total health care costs as those who did not . These cost estimates do not reflect additional indirect, non-medical, and lost productivity costs to patients, which may be substantial in a population with a chronic and significant illness impact on quality of life . Novel preventative approaches to reduce incidence of new Lyme disease cases, as well as physician and community educational interventions to increase awareness and reduce diagnostic delays and misdiagnosis, are needed to reduce costs and improve patient outcomes.
How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
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How Should A Tick Be Removed
Grasp the mouthparts with tweezers as close as possible to the attachment site. Be careful not to squeeze, crush or puncture the body of the tick, which may contain infectious fluids. Pull firmly and steadily upward to remove the tick. After removing the tick, thoroughly disinfect the bite site and wash hands. The NYSDOH has created a video on proper tick removal and a printable card with steps on how to remove ticks . See or call a doctor if there are concerns about incomplete tick removal. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these may actually increase the chance of contracting a tick-borne disease.
What Can Be Done To Prevent Lyme Disease
The best prevention of Lyme disease is through awareness. Generally, ticks cannot jump or fly onto a person. They wait in vegetation and cling to animals and humans when they brush by. When in a potentially tick-infested habitat take special care to prevent tick bites, such as wearing light-colored clothing and tucking pants into socks and shirt into pants. Check after every 2 to 3 hours of outdoor activity for ticks on clothing or skin. Brush off any ticks on clothing or skin before skin attachment occurs. A thorough check of body surfaces for attached ticks should be done at the end of the day. If removal of attached ticks occurs within 36 hours, the risk of tick-borne infection is minimal. For proper tick removal, please watch the video at Tick removal. A vaccine for Lyme disease is not currently available.
Insect repellents can be effective at reducing bites from ticks that can spread disease. If you decide to use a repellent, use only what and how much you need for your situation. More information on repellents can be found at Environmental Protection Agency – insect-repellents.
Domestic animals can carry ticks into areas where you live so it is important to check pets for ticks before they enter the home.
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Key Points For Healthcare Providers