Dig Deeper – Mental Illnesses

Neuropsychiatric Aspects and Neuropathology of Lyme Disease – Note: Scroll down to page 2

Abstract:

Lyme disease can be a complex. multi-systemic disease that causes psychiatric and neurologic symptoms. The spirochete B. burgdorferi is capable of remarkable antigenic variation, immune evasion, and persistence in the human host. Optimal duration of treatment for patients with chronic Lyme disease remains uncertain. The mental health practitioner can be of help primarily in identifying patients with undetected Lyme disease, guiding them to appropriate laboratory tests and diagnosticians, and providing support through the uncertainties regarding course and treatment.

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Lyme Disease -Tick-Borne Diseases and Neuropsychiatric Disorders

Abstract:

Now Lyme disease (Lyme borreliosis), -the new great imitator-, is the ultimate challenge to the breadth and depth of our knowledge. In psychiatry, we generally treat mental symptoms or syndromes rather than the underlying cause of a disorder. A greater awareness of immune reactions to infections and other contributors to mental illness enhances our psychiatric capabilities. Lyme disease, like syphilis, is caused by a spirochete with a multitude of possible manifestations and 3 stages: early with dermatological symptoms, disseminated, and late stage.

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Neurologic Complications of Lyme Disease    (from Neurology Today journal)

Abstract:

There is not much doubt about the neurological manifestations of acute Lyme disease – headache, neck rigidity,facial nerve palsy, peripheral pain, numbness, and weakness.

But more than 20 years after Lyme disease was first linked to the tick-borne spirochete Borrelia burgdorferi, there is considerable doubt about chronic syndromes attributed to borreliosis. Ambiguities in testing and overlapsin symptoms and in timing complicate diagnosis.

As the American Association of Neurologists (AAN) practice parameters for diagnosing patients with nervous system Lyme disease state: Highly rigorous and restrictive criteria should be required to establish a general cause-and-effect linkage between a given neurologic syndrome and B. burgdorferi infection. On the other hand, a slightly less restrictive basis may be appropriate for diagnosing an individual patient in whom failure to treat a probable, but not definite, infection might have significant adverse consequences.

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Higher Prevalence of Antibodies to Borrelia Burgdorferi in Psychiatric Patients

Abstract:

Results: Among the matched pairs, 166 (33%) of the psychiatric patients and 94 (19%) of the healthy comparison subjects were seropositive in at least one of the four assays.

Conclusions: These findings support the hypothesis that there is an association between Borrelia burgdorferi infection and psychiatric morbidity. In countries where this infection is endemic, a proportion of psychiatric inpatients may be suffering from neuropathogenic effects of Borrelia burgdorferi.

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Pillaging of Personalities – Case Study

Abstract:

Opening the door of my office one day in May 2001, I stepped back in surprise. The teenager standing there wore a brilliant orange, neck-to-foot jumpsuit. There were shackles with chains between her wrists and she was hobbled by more chains between her ankles. Surrounding her were two rather determined-looking women, looking at me doubtfully. I had known that 17- year-old Vicki was coming from a juvenile detention unit, but I hadn’t expected matrons, manacles, and chains.

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Lyme Neuroborreliosis and Dementia

Abstract:

Among 1594 patients seen for dementia the authors prospectively identified and studied 20 patients – 1.25 percent – with dementia and a positive intrathecal anti-Borrelia antibody index. Patients underwent a battery of neuropsychological tests brain, MRI, FDG-PET, and cerebrospinal fluid analysis. An etiological diagnosis of the dementia was made at the end of the follow-up of 2-8 years.

Conclusion: Pure Lyme dementia exists and has a good outcome after antibiotics. It is advisable to do Lyme serology in demented patients, and if serology is positive, to do CSF analysis. Neurodegenerative dementia associated with positive CSF analysis also exists, which may have been revealed by the involvement of Borrelia in the CNS.

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