Areas of clinical practice (choose one)
Lyme disease / Neuroborreliosis
Relapsing fever (Borrelia quintana)
Neuroinfectious / Tick Borne Diseases
Neuroinfectious diseases affect the nervous system, from the brain and spinal cord to muscles and nerves. There are a wide range of neuroinfectious diseases, including: meningitis, encephalitis, and neuro-Lyme disease. Treatments for these diseases may include antiviral, antibacterial, anti-inflammatory or anticonvulsive medicines, among other approaches. Treatments in this area are complex and evolving.
Lyme disease is caused by a bacterial organism that is transmitted to humans via the bite of an infected tick. Ticks can carry many bacteria, viruses, fungi and protozoans all at the same time and transmit them in a single bite. The most common tick-borne diseases in the United States include Lyme disease, babesiosis, anaplasmosis, ehrlichiosis, relapsing fever, tularemia, Rocky Mountain spotted fever (RMSF). Diseases acquired together like this are called co-infections.
Some people with Lyme disease develop a characteristic skin rash around the area of the bite. However, there are those who will not develop the rash, which can make Lyme disease hard to diagnose because its symptoms and signs mimic those of many other diseases.
Anywhere from 7 to 14 days (or in some cases, 30 days) following an infected tick's bite, the first stage of Lyme disease may begin with flu-like symptoms such as fever, chills, swollen lymph nodes, headaches, fatigue, muscle aches, and joint pain.
Neurological complications most often occur in the second stage of Lyme disease, with numbness, pain, weakness, Bell's palsy (paralysis of the facial muscles), visual disturbances, and meningitis symptoms such as fever, stiff neck, and severe headache. Other problems, which may not appear until weeks, months, or years after a tick bite, include decreased concentration, irritability, memory and sleep disorders, and nerve damage in the arms and legs.
ADHD / ADD
Pediatric Autoimmune Neuropsychiatric
Neuropsychiatry is a branch of medicine that deals with mental disorders attributable to diseases of the nervous system. It preceded the current disciplines of psychiatry and neurology, which had common training, however, psychiatry and neurology have subsequently split apart and are typically practiced separately.
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus and PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome (meaning triggered by things other than Strep, usually a virus). Both are types of Post Infectious Autoimmune Encephalitis, similar to Rheumatic Fever but instead of affecting the heart or other organs, the brain is targeted in PANDAS/PANS.
PANDAS & PANS are characterized by a sudden onset of neurological and psychiatric symptoms such as OCD, intrusive thoughts, irrational fears, behavior regression, separation anxiety, intense anxiety relating to many things, sensory issues, cognitive dysfunction, handwriting deterioration, even anorexia, and more.
If not treated early, varying degrees of disability can persist and more severe symptom flare ups are likely with re-infection of Strep or certain viruses.
Infections Induced Autoimmune Disorders
An autoimmune disease is a condition in which your immune system mistakenly attacks your body. The immune system normally guards against germs like bacteria and viruses. When it senses these foreign invaders, it sends out an army of fighter cells to attack them. Normally, the immune system can tell the difference between foreign cells and your own cells.
In an autoimmune disease, the immune system mistakes part of your body — like your joints or skin — as foreign. It releases proteins called autoantibodies that attack healthy cells.
Because the incidence of autoimmune diseases is rising, researchers suspect environmental factors like infections and exposures to chemicals or solvents might also be involved (1).
Autoimmune encephalitis refers to a group of conditions that occur when the body's immune systemmistakenly attacks healthy brain cells, leading to inflammation of the brain. People with autoimmune encephalitis may have various neurologic and/or psychiatric symptoms.
Neurologic symptoms may include impaired memory and cognition, abnormal movements, seizures, and/or problems with balance, speech, or vision. Psychiatric symptoms may include psychosis, aggression, inappropriate sexual behaviors, panic attacks, compulsive behaviors, euphoria or fear.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms. The disorder, which is sometimes called chronic relapsing polyneuropathy, is caused by damage to the myelin sheath (the fatty covering that wraps around and protects nerve fibers) of the peripheral nerves. Although it can occur at any age and in both genders, CIDP is more common in young adults, and in men more so than women. It often presents with symptoms that include tingling or numbness (beginning in the toes and fingers), weakness of the arms and legs, loss of deep tendon reflexes (areflexia), fatigue, and abnormal sensations. CIDP is closely related to Guillain-Barre syndrome and it is considered the chronic counterpart of that acute disease.
Other immune mediated disorders of the peripheral nervous system
Neuroimmunological disorders consist of diseases in which the immune system seems to attack the nervous system (central or peripheral). Diagnosis of neuroimmunological disorders requires detailed clinical evaluation and appropriately targeted diagnostic testing, such as neurophysiologic testing, neuro-imaging, blood tests and sometimes cerebrospinal fluid assessment. Treatment usually targets the abnormal immune response, directly addressing the disorder, or can be directed at easing symptoms.
Myalgic encephalitis (ME)
A systemic disease is one that affects a number of organs and tissues, or affects the body as a whole. Examples of systemic diseases include: mastocytosis, including mast cell activation syndrome, chronic fatigue syndrome, systemic vasculitis, fibromyalgia, coeliac disease, and myasthenia gravis
Chronic fatigue syndrome (CFS), also referred to as myalgic encephalomyelitis (ME), is a medical condition characterized by long-term fatigue and other long-term symptoms that limit a person's ability to carry out ordinary daily activities. While the cause is not understood, proposed mechanisms include biological, genetic, infectious and psychological
Fibromyalgia (FM) is a medical condition characterised by chronic widespread pain and a heightened pain response to pressure. Other symptoms include tirednessto a degree that normal activities are affected, sleep problems and troubles with memory. Some people also report restless legs syndrome, bowel or bladder problems, numbness and tingling and sensitivity to noise, lights or temperature. Fibromyalgia is frequently associated with depression, anxiety and posttraumatic stress disorder. The cause of fibromyalgia is unknown; however, it is believed to involve a combination of genetic and environmental factors, with each playing a substantial role.
Alzheimer’s disease (AD)
Parkinson’s disease (PD)
ALS / Motor neuron diseases
Neurodegenerative disease is an umbrella term for a range of conditions which primarily affect the neurons in the human brain.
Neurons are the building blocks of the nervous system which includes the brain and spinal cord. Neurons normally don’t reproduce or replace themselves, so when they become damaged or die they cannot be replaced by the body.
Examples of neurodegenerative diseases include Parkinson’s, Alzheimer’s, and Huntington’s disease.
Neurodegenerative diseases are incurable and debilitating conditions that result in progressive degeneration and / or death of nerve cells. This causes problems with movement (called ataxias), or mental functioning (called dementias).