What Happens At Your Appointment
The GP will ask about your symptoms and consider any rash or recent tick bites you know about.
Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there’s not always an obvious rash.
2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.
You may need to be retested if you still have Lyme disease symptoms after a negative result.
Symptoms Following Treatment: Post
4.3.1 Diagnostic criteria
PTLDS is a syndrome that has not yet been scientifically defined and therefore not uniformly accepted. It is to be diagnostically differentiated from confirmed late manifestations of Lyme borreliosis, symptoms caused by the persistence of reproducing pathogens, and symptoms caused by partial recovery.
In the case of Lyme neuroborreliosis, objective neurological deficits and inflammatory changes in the cerebrospinal fluid usually respond well to antibiotic treatment , , , , , . However, some patients are reported to have developed non-specific symptoms of fatigue, paraesthesia, muscle and joint pain as well as concentration and memory issues despite antibiotic treatment , , , . If the non-specific symptoms last more than 6 months, some authors refer to this as post-treatment Lyme disease syndrome , . Predictors for the development of fatigue 30 months after treatment have been described as the delayed onset of antibiotic treatment, severe neurological symptoms before treatment, and incomplete regression of neurological symptoms 4 months after treatment .
4.3.2 Frequency
In a non-systematic review, it was reported that 020% of patients being treated for Lyme borreliosis with antibiotics had symptoms of so-called PTLDS after treatment of Lyme neuroborreliosis the percentage was between 5 and 54% .
4.3.3 Subjective symptoms in case-control studies
4.3.4 Neuropsychological symptoms in case-control studies
4.3.5 Studies on antibiotic treatment
Summary
Neurological And Psychiatric Issues Associated With Lyme Disease And Tbrf
Home » Tick Talk » Neurological and Psychiatric Issues Associated with Lyme Disease and TBRF
Chronic illness often has significant impacts on mental health, and Lyme disease is no different. With the accuracy and sensitivity of todays recommended Lyme testing still so lacking, many Lyme patients have to wait too long to get accurate diagnoses and treatment. To compound this problem, many patients with Lyme-like symptoms are not even tested for the similar, but biologically distinct, Tick-Borne Relapsing Fever . That gives infections time to spread throughout the body and cause neurological and psychiatric symptoms.
This article will outline the direct and indirect effects that Borreliosis both Lyme disease and TBRF can have on mental health, including how and why untreated Lyme can develop into neurological Lyme disease.
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What Are The Signs And Symptoms Of Stage 3 Lyme Disease
Late or chronic Lyme disease refers to manifestations that occur months to years after the initial infection, sometimes after a period of latency. Signs and symptoms of chronic Lyme disease are primarily rheumatologic and neurologic. Acrodermatitis chronica atrophicans, the cutaneous feature of late-stage Lyme disease, is found almost exclusively in European patients.
Most patients presenting with late disease do not have a history of erythema migrans, because the rash typically leads to earlier treatment, which prevents the development of late disease. However, other manifestations of the disease may coexist or may have occurred in the past. Thus, a history of Bell palsy, aseptic meningitis, arthritis, acral paresthesias or dysesthesias , or cognitive dysfunction may be diagnostically useful.
Maladaptive host responses can lead to a variety of syndromes in stage 3, as follows :
- Postinfectious Lyme arthritis Massive inflammatory synovial proliferation, usually in a knee
- Posttreatment Lyme disease syndrome Pain, neurocognitive impairment, fatigue
- Autoimmune joint disease Rheumatoid arthritis, psoriatic arthritis, or peripheral spondyloarthropathy
- Autoimmune neurologic disease Chronic idiopathic demyelinating polyneuropathy
Lyme arthritis is the hallmark of stage 3 Lyme disease. It tends to involve large joints . Arthritis must be differentiated from arthralgia, which is common in early disease.
References
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Resources On Managing Lyme Disease
If you are looking for more information on lyme disease or have a specific question, our information specialists are available business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9am to 8pm ET.
Additionally, we encourage you to reach out to Lyme disease support groups and nonprofits, including:
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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.
What Are The Symptoms Of Chronic Lyme Disease
Chronic Lyme disease is not a recognized condition. However, some symptoms can persist past treatment. This has led doctors to describe the phenomenon as post-treatment Lyme disease syndrome . PTLDS occurs in about 520% of people who receive Lyme disease treatment. It may cause symptoms such as:
- fatigue
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Lyme Disease Therapy Available In Chadds Ford Pennsylvania
If you have more questions or concerns about Lyme Disease or the available treatment methods, reach out to the specialists at the Hope Brain and Body Recovery Center for more information. Call our offices to speak with a representative from our team or schedule a consultation online today!
Book a 15min. Free Phone Consultation
What To Do If You Find A Tick
Depending on the area, anywhere from less than 1% to more than 50% of ticks carry Lyme disease, according to Johns Hopkins Medicine. If you find a tick on your body, you should remove it. ILADS recommends contacting your doctor immediately if you’ve been bitten by a black-legged tick, before symptoms of Lyme disease appear .
According to Bran, Lyme infection may be prevented if the tick bite happened within 72 hours of you starting treatment.
Not all ticks carry Lyme disease.
ILADS recommends saving the tick in a container with a lid or a ziplock bag. This allows you to send it in for testing or to get confirmation by your doctor.
How long does an infected tick need to be attached to pass on Lyme disease? Expert advice varies
But the sooner you spot and remove the tick, the better.
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Pots Constipation And Lyme Disease
POTS stands for postural orthostatic tachycardia syndrome which means the heart rate will increase when someone changes position, from laying or sitting to standing. POTS is very common in late-stage Lyme disease since the autonomic nervous system does not maintain tone in blood vessels causing a drop in blood pressure. When the blood pressure drops, the heart rate has to increase to stabilize blood pressure. Mast cell activation syndrome is another common cause of POTS and MCAS is frequently seen as a consequence of Lyme disease.
Another common symptom associated with autonomic nervous system dysfunction is constipation. Termed gastroparesis, constipation can happen when the nerve that signals intestinal muscular contraction become damaged by the bacteria and the resulting immune response.
What Lyme Disease Does To Your Brain
is a bacterial infection that you catch when an infected deer tick bites you. The first symptoms can appear within a few days or weeks. They include a target-shaped , , fever, , , and . Often, doctors promptly recognize and treat Lyme disease with antibiotics. But when treatment is delayed, the infection can spread to other areas, including the nerves, liver and eyes. It can also spread to the central nervous systemthe brain and spinal cordand cause the following problems.
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What Might A Doctor Misdiagnose Lyme Disease As
Ticks can carry a variety of different organisms and diseases with them.
The lone star tick can carry a disease known as southern tick-associated rash illness. The rash it causes to a Lyme disease rash. In addition, it can cause similar symptoms to Lyme disease, including fever, fatigue, joint and muscle aches, and headache.
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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Six Cases Of Neurological Lyme Disease
Clinicians from Mayo Clinic describe 6 cases of neurological Lyme disease in the journal Open Forum Infectious Diseases. Five of the cases presented with Bannwarth syndrome , an uncommon manifestation of neurologic Lyme disease.
Bannwarth syndrome is characterized by painful radiculopathy, neuropathy, varying degrees of motor weakness and facial nerve palsy, and cerebrospinal fluid lymphocytic pleocytosis. Five patients presented with peripheral nervous system involvement , which is consistent with BWS, writes Shah and colleagues. Three of the cases of neurological lyme disease are discussed below.
61-year-old male
A 61-year-old male, who had a history of daily exposure to ticks, presented with progressive back pain, upper torso and extremity paresthesias, right-sided facial droop, and blurry vision in the right eye, writes Shah. Four weeks prior, he was treated for an EM rash with 5 days of doxycycline, given twice daily.
Test results indicated positive IgM and IgG antibodies to B. burgdorferi and he was diagnosed with neurologic Lyme disease and BWS. According to Shah, the patient demonstrated significant neurologic improvement following 4 weeks of intravenous ceftriaxone.
62-year-old female
A 62-year-old female presented with subacute onset of lower extremity weakness. This progressed over a 3-week period to flaccid paralysis, writes Shah. The woman also complained of radiating low back and abdominal pain with associated numbness.
29-year-old male
Direct Detection Of The Pathogen Using Molecular Biological Detection Methods And Culture
In exceptional cases ), a Borrelia infection can be underpinned by pathogen detection in CSF , . However, for acute Lyme neuroborreliosis, the sensitivity of the pathogen detection in CSF through culture or a PCR test is only 1030% , . Pathogen detection is expected to have a higher sensitivity when the duration of the disease is short than in prolonged cases. For example, 50% of patients with acute Lyme neuroborreliosis tested positive with PCR compared to only 13% of patients with a prolonged course of the disease . Detection in the cerebrospinal fluid using a PCR test is generally preferred because results can be provided faster than for cultures. If the results are positive, a species diagnosis should be made by analysing the PCR products. Detection of the pathogen in blood is not recommended because this method is even less sensitive . The specificity of the PCR test depends to a large extent on the quality of the laboratory performing it. Therefore, the investigation should be explicitly limited to special, designated reference laboratories, especially as further molecular biological confirmation tests are required when the results are positive . In every case, the PCR result must be interpreted in relation to the symptoms and the serology results. For example, positive PCR test results for patients with a prolonged disease and negative serology are very likely to be false positive .
Recommendations for direct detection using molecular biological methods and culture
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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.
Can Lyme Cause Neuropathy
Neuropathy is a collection of symptoms that arise when nerves become damaged. Although it is most often associated with health conditions such as diabetes, Lyme disease can actually lead to neuropathy if the borrelia bacteria manages to infiltrate and damage the nerves in the nervous system.
The type of neuropathy that develops in a person with neurological Lyme disease is typically referred to as peripheral neuropathy, which leads to numbness and weakness in the limbs, paralysis of facial muscles, and pain in the limbs.
It can be hard to determine if neuropathy is caused by Lyme disease in someone who is unaware that they have the condition, so diagnosing Lyme disease based on the symptoms of neuropathy alone can be a difficult process.
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What Are Neurologic Manifestations Of Lyme Disease
Neurologic involvement, also known as Lyme neuroborreliosis, is reported in 5-20% of cases. In the United States, cranial neuropathy is the most common manifestation of early neurologic Lyme disease. Other manifestations include meningitis and encephalopathy.
Cranial neuropathies, especially facial nerve palsy , develop in approximately 3% of Lyme disease patients. In endemic areas, Lyme disease is the most commonly identified cause of acquired facial palsy, especially in children. Headache, absence of previous herpetic lesions, and meningeal symptoms are noted in most pediatric Lyme disease patients with facial palsy.
When meningitis is involved, symptoms usually occur 2-10 weeks following infection. Headache, neck pain or stiffness, and photophobia typically indicate meningeal irritation. The headache of Lyme disease typically is described as waxing and waning, and the severity varies from mild to severe, even in patients with frank meningitis. Persistent headache alone is a rare presentation of Lyme disease but should be considered in patients in endemic areas during summertime.
Borrelia encephalopathy most commonly manifests as a mild confusional state accompanied by disturbances in memory, concentration, mood, sleep, personality, and/or language occurring months to years after the infection. Depression and irritability are also common.
References
Feder HM Jr. Lyme disease in children. Infect Dis Clin North Am. 2008 Jun. 22:315-26, vii. .
What To Do If You Find A Tick: Lyme Disease Symptoms And More
Tick bites may go unnoticed, and many people with Lyme never get a classic “bull’s-eye” rash. Here’s what to know about the mysterious disease.
Jessica Rendall
Jessica is a Wellness News Writer who wants to help people stay informed about their health. She’s from the Midwest, studied investigative reporting at the Missouri School of Journalism and is now based in NYC.
Lyme disease, an illness caused by bacteria transmitted to humans through the bites of certain species of ticks, has been notoriously misunderstood and underdiagnosed. But the deer or black-legged ticks that cause the illness in the US may be a growing problem.
Traditionally, Lyme disease was thought of as a problem in the wooded Northeastern region of the US. Last year, however, reports started showing that Lyme disease is a growing problem in most parts of the country, including California and even urban areas.
Dr. James Marvel, an emergency medicine doctor at Stanford Health Care and wilderness medicine expert, has researched the contributing factors to the spread of Lyme disease in the US. In an interview with CNET, he said that data over the last few decades shows that Lyme disease has “blossomed” in a number of US states and counties, particularly in the Northeast.
“It’s not as simple as saying, ‘One hot day means there’s going to be more ticks,'” he explained.
“You’re seeing a shift toward going out in order to be socially distant,” Bran said.
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Administering Effective Lyme Treatments
Conventional medicine views Lyme disease treatment as an easy and straightforward proposition, a dose of antibiotics and you’re cured. Though this may work in the earliest stage of the disease, it is when Lyme goes undiagnosed or mistreated and allowed to get to a chronic state when treatment becomes more difficult.
Lyme disease will often be accompanied by co-infections which work in synergy with borrelia to exacerbate symptoms making the disease difficult to treat. Lyme disease also has the unique ability to bypass the body’s blood-brain barrier, a barrier which typically prevents foreign invaders from affecting the brain, allowing the disease to enter the nervous system accounting for Lyme’s many complex neurological symptoms. Antibiotic treatment protocols alone do not account for this invasion of the body’s nervous system through the blood-brain barrier and therefore are not likely to have lasting results. To effectively treat chronic Lyme disease, antibiotics need to also move past the blood-brain barrier .
Borrelia Attacking Neurons in the Brain
