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​Neuroinfectious (Lyme + Co-infections)

Neuroinfectious Disease

Neuroinfectious diseases affect the nervous system, from the brain and spinal cord to muscles and nerves. Today, Lyme disease is the most commonly reported tick-borne disease in the United States and Europe. When discussing neuro-infectious diseases, Lyme disease can be considered one of the more novel and mysterious entities currently in existence.

 

The culprits behind Lyme disease are the Borrelia species of bacteria. In the USA, Borrelia burgdorferi causes the majority of cases, while in Europe and Asia Borrelia afzelii and Borrelia garinii carry the greatest burden of disease. The clinical manifestations of Lyme disease have been identified as early localized, early disseminated, and late chronic. The neurological effects of Lyme disease include both peripheral and central nervous systems involvement, including focal nerve abnormalities, cranial neuropathies, painful radiculoneuritis, meningitis, and/or toxic metabolic encephalopathy, known as Lyme encephalopathy

Neuroinfectious diseases

There are a wide range of neuroinfectious diseases, including:

  • Meningitis and encephalitis, in which inflammation of the membranes surrounding the brain and spinal cord caused by bacterial or viral infection may lead to disability or death.

  • Progressive multifocal leukoencephalopathy, a viral infection that can lead to loss of coordination, language ability and memory.

  • Neurosarcoidosis, an inflammatory disease of the nervous system marked by facial weakness and headache that may lead to a chronic condition.

  • Transverse myelitis, an inflammation of both sides of the spinal cord that can cause pain, weakness, paralysis, sensory problems, or bladder and bowel dysfunction.

Co-Infections of Neuro-Lyme

While Lyme is the most prevalent tick-borne disease in the U.S., there are a number of other infections transmitted by ticks, pets, animals, and environmental factors. To name a few:

 

Lyme Disease Stages

Lyme disease occurs in three stages: early localized, early disseminated and late disseminated. However the stages CAN overlap and not all patients go through all three. A bull’s-eye rash is usually considered one of the first signs of infection, but many people develop a different kind of rash or none at all. In most cases, Lyme symptoms can start with a flu-like illness. If untreated, the symptoms can continue to worsen and turn into a long-lived debilitating illness

STAGE 1 - Early Localized Lyme

Symptoms may begin hours, a few days or even weeks after a tick bite. Lyme is the easiest to cure at this stage. Symptoms may include:

  • skin rash, which may or may not look like a bull’s eye

  • flu-like illness, including chills and fever

  • fatigue

  • headache and stiff neck

  • muscle soreness and joint pain

  • swollen lymph nodes

  • sore throat

STAGE 2 - Early Disseminated Lyme

Early disseminated Lyme may occur several weeks or months after the tick bite. Bacteria are beginning to spread throughout the body. In addition to flu-like symptoms, this stage is often characterized by increase in symptoms such as:

  • chills

  • fever

  • headaches

  • fatigue

  • pain, weakness or numbness in the arms, legs

  • vision changes

  • heart problems, such as palpitations, chestpain

  • rash may appear on body

  • facial paralysis (Bell’s palsy)

STAGE 3 - Late Disseminated Lyme

If Lyme disease isn’t promptly or effectively treated in the first two stages, late disseminated Lyme occurs weeks, months or even years after the tick bite. The Lyme bacteria have spread throughout the body and many patients develop chronic arthritis as well as an increase in neurological and cardiac symptoms. Symptoms include:

  • arthritis in joints or near the point of infection

  • severe headaches or migraines

  • vertigo, dizziness

  • migrating pains that come and go in joints/tendons

  • stiff, aching neck

  • sleep disturbances, insomnia

  • disturbances in heart rhythm

  • mental fogginess, concentration issues

  • numbness in the arms, legs, hands or feet

  • problems following conversations and processing information

  • severe fatigue

Testing and Treatment

Treatments in this area are complex and evolving. People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. After treatment, a small number of people still have some symptoms, such as muscle aches and fatigue

(known as post-Lyme disease syndrome). Some experts believe that certain people who get Lyme disease are predisposed to develop an autoimmune response that contributes to their symptoms.

Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil. People with certain neurological or cardiac forms of illness may require intravenous treatment. In up to 80% of cases, the antibiotic cures the infection. If it doesn’t, patients might get other antibiotics either by mouth or intravenously. For early disseminated Lyme disease, which may happen when a Lyme infection goes untreated, oral antibiotics are recommended for symptoms such as facial palsy and abnormal heart rhythm. Intravenous antibiotics are recommended if a person has meningitis, inflammation of the lining of the brain and spinal cord, or more severe heart problems. In late-stage Lyme, a patient may receive oral or intravenous antibiotics. 

 

Antibiotics are proven treatment for Lyme disease. Some people who have unexplained signs and symptoms or chronic disease might believe they have Lyme disease even if it's not been diagnosed. There are a variety of alternative treatments that people with Lyme disease or people who think they have Lyme disease turn to for relief.

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