Neuropsychiatric Lyme

[LymeEnigma]

The Neuropsychiatric Assessment of Lyme Disease
Robert Bransfield, M.D.

Objective: A structured clinical interview is proposed to assist in the overall clinical assessment when late state Lyme disease is suspected.

Method: From a combination of clinical experience, journal review, and discussion with colleagues, a structured interview was developed. Information from patients with late stage neuropsychiatric Lyme disease (NPLD) was entered into a database to serve as a reference point for diagnosis and tracking the patient’s status after diagnosis.

Results: An analysis of symptoms acquired from a thorough history and mental status exam can be quite helpful towards the total clinical assessment when suspecting late stage Lyme disease. Details are provided in the text of this article.

Conclusion: When NPLD is a diagnostic possibility, a detailed, well-focused interview and mental status exam is proposed, and a database of symptoms seen in NPLD is established. It is recommended to continue perfecting the assessment as well as expanding the database. If diagnostic accuracy is improved, there would be better consensus regarding treatment strategies.

Full article: www.mentalhealthandillness.com/tnaold.html

[LymeEnigma]

Lyme Disease, Comorbid Tick-Borne Diseases, and Neuropsychiatric Disorders
Robert C. Bransfield, MD
www.psychiatrictimes.com/display/article/10168/55056

[LymeEnigma]

Functional Brain Imaging and Neuropsychological Testing in Lyme Disease

Brian A. Fallon, Sam Das, Jeffrey J. Plutchok, From The New York State Psychiatric Institute, the Department of
Felice Tager, Kenneth Liegner, and Ronald Van Heertum Psychiatry of Columbia University and Columbia-Presbyterian Medical
Center, and the Department of Nuclear Medicine of Columbia-
Presbyterian Medical Center, New York, New York; and private practice
in Armonk, New York

Abstract:

Differentiating neuropsychiatric Lyme disease from a primary psychiatric disorder can be a
daunting task. This article describes how functional brain imaging and neuropsychological testing
can be particularly valuable in helping to make diagnostic distinctions. In addition to a review of
the relevance of functional imaging to neuropsychiatry in general, recent findings are presented
regarding the use of single photon emission computed tomographic (SPECT) imaging in Lyme
disease.

Full article: www.journals.uchicago.edu/doi/pdf/10.1086/516175

[LymeEnigma]

Pol Merkur Lekarski. 2008 May;24(143):433-5.
[Borreliosis--simultaneous Lyme carditis and psychiatric disorders--case report]
[Article in Polish]

Legatowicz-Koprowska M, Gziut AI, Walczak E, Gil RJ, Wagner T.

Institute of Rheumatology in Warsaw, Department of Pathology, Poland. [e-mail]

Borreliosis is a multisystemic disease transmitted by ticks. Its diagnosis still remains a challenge because of the varied clinical picture and of difficulties in detection of the etiological agent (Borrelia burgdorferi). We report a case of a 53-years-old woman admitted to the Clinic of Cardiology due to life-threatening arhythmias with simultaneous deficits in concentration and memory. A suspicion of borreliosis was driven from the presence of cardiac symptoms as well as of psychiatric and from the case histories of a tick bite. The diagnosis was confirmed both by specific serological test and endomyocardial biopsy which revealed spirochetes. The patient responded to treatment with doxycyclin and ceftriaxone. Cardiologic disorders retreated entirely, while cognitive deficits did only partly.

PMID: 18634389 [PubMed - in process]
www.ncbi.nlm.nih.gov/pubmed/18634389?ordinalpos=18&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum