What are symptoms and signs of Lyme disease?
Lyme disease affects different areas of the body in varying degrees as it progresses. The site where the tick bites the body is where the bacteria enter through the skin. As the bacteria spread in the skin away from the initial tick bite, the infection causes an expanding reddish rash that is often associated with "flu-like" symptoms. Later, it can produce abnormalities in the joints, heart, and nervous system.
Lyme disease is medically described in three phases as: (1) early localized disease with skin inflammation; (2) early disseminated disease with heart and nervous system involvement, including palsies and meningitis; and (3) late disease featuring motor and sensory nerve damage and brain inflammation as well as arthritis.
In the early phase of the illness, within days to weeks of the tick bite, the skin around the bite develops an expanding ring of unraised redness. There may be an outer ring of brighter redness and a central area of clearing, leading to a "bull's-eye" appearance. This classic initial rash is called "erythema migrans" (formerly called erythema chronicum migrans). Patients often can't recall the tick bite (the ticks can be as small as the periods in this paragraph). Also, they may not have the identifying rash to signal the doctor. More than one in four patients never even develop a rash. The redness of the skin is often accompanied by generalized fatigue, muscle and joint stiffness, swollen lymph nodes ("swollen glands"), and headache, resembling symptoms of a virus infection.
The redness resolves, without treatment, in about a month. Weeks to months after the initial redness of the skin the bacteria and their effects spread throughout the body. Subsequently, disease in the joints, heart, and nervous system can occur.
The later phases of Lyme disease can affect the heart, causing inflammation of the heart muscle. This can result in abnormal heart rhythms and heart failure. The nervous system can develop facial muscle paralysis (Bell's palsy), abnormal sensation due to disease of peripheral nerves (peripheral neuropathy),numbness and tingling of limbs, meningitis, and forgetfulness or confusion. Arthritis, or inflammation in the joints, begins with swelling, stiffness, and pain. Some have pain without swelling. Usually, only one or a few joints become affected, most commonly the knees. The arthritis of Lyme disease can look like many other types of inflammatory arthritis and can become chronic.
Lyme Encephalitis can look a lot like MS on an MRI, but is rare in the US because most people are treated before it gets to that point.
Nevertheless, there may be patients with LE in the US who appear to have MS. The white matter MRI hyperintensities in Lyme disease tend to be smaller than would be typical in MS. It is also uncommon to have oligoclonal bands in the CSF of patients with Lyme disease while this is commonly seen in MS patients.
If the Bb Lyme Index is positive in the CSF/serum comparison or if the CSF PCR is positive, then the diagnosis of Lyme encephalomyelitis is made.
At times when a patient may have a positive serologic test for Lyme disease and a reasonable exposure history to a Lyme endemic area and a clinical and MRI profile typical of MS, physicians may consider a trial of IV antibiotic therapy to see if there is a resolution or improvement of the hyperintense lesions on the MRI scan.
Patients may have MS and not Lyme. Patients may have MS and Lyme together by chance and the two are unrelated. Or patients may have Lyme and not MS.
Sources: http://asp.cumc.columbia.edu/psych/a...iry.asp?SI=569
http://www.medicinenet.com/lyme_disease/page2.htm
Lyme disease affects different areas of the body in varying degrees as it progresses. The site where the tick bites the body is where the bacteria enter through the skin. As the bacteria spread in the skin away from the initial tick bite, the infection causes an expanding reddish rash that is often associated with "flu-like" symptoms. Later, it can produce abnormalities in the joints, heart, and nervous system.
Lyme disease is medically described in three phases as: (1) early localized disease with skin inflammation; (2) early disseminated disease with heart and nervous system involvement, including palsies and meningitis; and (3) late disease featuring motor and sensory nerve damage and brain inflammation as well as arthritis.
In the early phase of the illness, within days to weeks of the tick bite, the skin around the bite develops an expanding ring of unraised redness. There may be an outer ring of brighter redness and a central area of clearing, leading to a "bull's-eye" appearance. This classic initial rash is called "erythema migrans" (formerly called erythema chronicum migrans). Patients often can't recall the tick bite (the ticks can be as small as the periods in this paragraph). Also, they may not have the identifying rash to signal the doctor. More than one in four patients never even develop a rash. The redness of the skin is often accompanied by generalized fatigue, muscle and joint stiffness, swollen lymph nodes ("swollen glands"), and headache, resembling symptoms of a virus infection.
The redness resolves, without treatment, in about a month. Weeks to months after the initial redness of the skin the bacteria and their effects spread throughout the body. Subsequently, disease in the joints, heart, and nervous system can occur.
The later phases of Lyme disease can affect the heart, causing inflammation of the heart muscle. This can result in abnormal heart rhythms and heart failure. The nervous system can develop facial muscle paralysis (Bell's palsy), abnormal sensation due to disease of peripheral nerves (peripheral neuropathy),numbness and tingling of limbs, meningitis, and forgetfulness or confusion. Arthritis, or inflammation in the joints, begins with swelling, stiffness, and pain. Some have pain without swelling. Usually, only one or a few joints become affected, most commonly the knees. The arthritis of Lyme disease can look like many other types of inflammatory arthritis and can become chronic.
Lyme Encephalitis can look a lot like MS on an MRI, but is rare in the US because most people are treated before it gets to that point.
Nevertheless, there may be patients with LE in the US who appear to have MS. The white matter MRI hyperintensities in Lyme disease tend to be smaller than would be typical in MS. It is also uncommon to have oligoclonal bands in the CSF of patients with Lyme disease while this is commonly seen in MS patients.
If the Bb Lyme Index is positive in the CSF/serum comparison or if the CSF PCR is positive, then the diagnosis of Lyme encephalomyelitis is made.
At times when a patient may have a positive serologic test for Lyme disease and a reasonable exposure history to a Lyme endemic area and a clinical and MRI profile typical of MS, physicians may consider a trial of IV antibiotic therapy to see if there is a resolution or improvement of the hyperintense lesions on the MRI scan.
Patients may have MS and not Lyme. Patients may have MS and Lyme together by chance and the two are unrelated. Or patients may have Lyme and not MS.
Sources: http://asp.cumc.columbia.edu/psych/a...iry.asp?SI=569
http://www.medicinenet.com/lyme_disease/page2.htm
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