Lyme disease symptoms?

Answer:

In the case of Lyme disease, the agent is the pirochetal organism Borrelia burgdorferi. The primary disease vectors are ticks (Ixodes scapularis or Ixodes dammimi in the Eastern states; and the Ixodes pacificus in the western states.) The tick (Ixodes spp.), also known as the Deer tick can also carry the organism in other less disease prevalent areas.

The vector has a two-host lifecycle that requires first the white-footed mouse as a host for the first two years, then it spends its third and final year on its definitive host, the deer. Therefore, familiarity with where these two host are present may suggest the possibility of infection.

The first sign is usually flu like symptoms accompanied with joint pain. Typically, there are distinct phases:

1. Characteristically, the tick bite develops into a "bull's eye" skin lesion erthema migrans in about 70% to 80% of the cases; which, then, spreads as a rash. This initial phase may also show signs of nonspecific malaise, headache, aching joints (arthralgia), fever, myalgia, and regional lymphadenopathy.

2. Then, after a period of a few weeks, the organism develops through hermatogenous spread and my manifest as subtle encephalitis with headache and cognitive difficulties. Stiff neck and cranial neuropathy (including facial palsy) is common. The loss of the ability to coordinate muscular movement (Ataxia) may also be present, mimicking in some ways Bells palsy. Motor and sensory radiculoneuritis may also be present which may result in referred pain, numbness (especially in the lower legs). Further possible complications during the period are myelitis and visual disturbances because of the organism causing inflammation in the spinal cord and/or the bone marrow. This phase, in a significant number of cases, is associated with a disorder of the central nervous system caused by infection with a spirochete of the genus Borrelia.

3. Finally, the chronic phase, which may appear months after the initial infection. Common findings are arthritis or inflammation in the joints (oligoarthritis) which typically affects the knee. Pain is usually out of proportion to the swelling, however. Musculoskeletal pain is also present, as well as, spinal radiculopathy with paresthesias, encephalopathy, and the symptom of fibromyalgia, commonly referred to as a chronic fatigue. This stage is associated with borreliosis, which in turn, may cause cardiac arrhythmias and even compromise the entire nervous system, and include respiratory distress.

Lyme disease is generally considered diagnostically as a disease of last resort.

Jim M. Roane, N.D.

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