MS Multiple Sclerosis
Multiple sclerosis
Spirochetes and MS References
Old references. Posted by Joanne Drayson at Sunday, August 29, 2010
There are more than 50 such MS-spirochete references prior to World War II and going back to as far as 1911, and published in such prestigious journals as the Lancet.
1911 Buzzard Spirochetes in MS Lancet
1913 Bullock MS Agent in Rabbits Lancet
1917 Steiner Spirochetes The Cause of MS Med Kiln
1918 Simmering Spirochetes in MS by Darkfield Micro
1918 Steiner G. Guinea Pig Inoculation with MS infectious agent from Human
1919 Steiner MS Agent Inoculation into Monkeys
1921 Gye F. MS Agent In Rabbits Brain 14:213
1922 Kaberlah MS Agent In Rabbits Deutch Med Works
1922 Sicard MS Spirochetes in Animal Model Rev Neurol
1922 Stepanopoulo Spirochetes in the CSF of MS Patients
1923 Shhlossman MS Agent in Animal Model Rev Neuro
1924 Blacklock MS Agent in Animals J. of Path and Bac
1927 Wilson The Rat as A Carrier of MS British Med Journal
1927 Steiner G Understanding the Pathogenesis of MS
1928 Steiner Spirochetes in the Human Brain of MS Patients
1933 Simons Spirochetes in the CSF of MS Patients
1939 Hassin Spirochete-like formations in MS
1948 Adams Spirochetes within the Ventricle Fluid of Monkeys Inoculated from Human MS
1952 Steiner Acute Plaques in MS and The Pathogenic Role of Spirochetes as the Etiological Factor Journal of Neuropathology and Exp Med 11: No 4:343 1952
1954 Steiner Morphology of Spirochaeta Myelophthora (Myelin Loving) In MS Journal of Neuropathology and Exp Neurol 11:4 343 1954
1957 Ichelson R. Cultivation of Spirochetes from Spinal Fluids of MS Cases with Negative Controls Procl. Soc. Exp. Biol Med 70:411 1957
Commentary below by Ivan Hooper...
If you follow the European Medical Literature concerning Multiple Sclerosis from 1911 to 1939, you find that in France, Germany and England; there were independent researchers all observing similar things and coming to similar conclusions:
1) Spirochetes are often found in conjunction with the lesions in the brains of patients who have died with MS.
2) These spirochetes can be isolated and can infect many mammalian animal models; including: mice, rats, hamsters, guinea pigs, rabbits, dogs, and primates.
3) The spirochetes could be re-isolated from the brains of the infected animals and be inoculated into more un-infected animals and re-isolated from their brains.
Why in the 21st century have spirochetes been ignored as infectious agents of the human brain?
The short answer is that to save time and money we no longer do things old school by which I mean: no one does brain autopsies and physically stains or cultures for the bacteria.
Instead we have gotten lazy and cheap in our research and tried to rely on blood tests and CSF fluid to give us the answers. But those tests are wholly inadequate to detect living spirochetes sequestered inside brain cells.
Now this is the important part about detecting spirochetes within human tissues. First you cannot find spirochetes if you don’t properly stain the tissue for them. Spirochetes are completely invisible under the microscope without special stains.
In 1911, chemists and microbiologists only had silver stains that stained nucleic acids, and for some reason these stains caused the entire spirochete to turn black and opaque. (It turns out that Borrelia’s nucleic acid is nearly evenly distributed under its inner membrane like a web of DNA that fits the entire bacterium like a nylon stocking surrounding the cytoplasm. In other words the silver stain outlines the shape of the bacterium.)
The trouble with silver stains is that they cannot enter human cells. So for nearly a century it was reported that spirochetes were mostly extracellular and found outside all human cells. Not only was this a wrong conclusion based on inadequate methods, but the consequences of not recognizing an intracellular infection was and still is dire. Why?
Because intracellular infections can be incurable or at the very least more difficult to treat; there is almost no way to determine an end point where a bacteriological cure has been obtained.
Next is that spirochetes are known to disappear by changing to cyst forms, and also by going intracellular. So these puzzled researchers that were only seeing classical formed spirochetes in 1 in 20 MS patients, may have been seeing them all along and not realizing what they were seeing. How can we conclude this?
Researchers wanted to see if the infectious agent was still in MS lesions despite no visible spirochetes.
Researchers removed brain tissue at necropsy of human patients and inoculated the tissue into uninfected animals. In some cases, this caused the infection to occur and show up in the brain of the animals; sometimes the classical-form spiral shaped spirochetes emerged.
All of this meticulous work was done prior to WW II, and completely untainted by today’s politics and special interests; yet this body of work is being wholly ignored.
___________________
The above should be of interest to anyone suffering with Multiple Sclerosis, Parkinson's, Motor Neurons or any other Neurological Illness.
____________________
Message From Lisa Torrey- President, National Tick Borne Disease Advocates
"The reason MS can be confused with Lyme is perhaps because it is Lyme? Until we know what causes MS, the door is open. My MS responds very well to Lyme/TBD treatment protocols. Go figure!
I did a lot of research in the beginning when I was first diagnosed with MS. Do I go down the MS route...which gave me no hope...or accept MS could be caused by a pathogen?
Below is some of what I dug up in the early years. The choice was clear for me after I read the Geo-Statistical map which shows MS cases vs. Lyme cases... they overlap!
Here is something to consider if you have been diagnosed with MS:
Geo-Statistical Analysis of Possible Spirochetal Involvement in Multiple Sclerosis.
By Megan M. Blewett, Margaret Kilduff
At the time this was written, Ms. Blewett was a brilliant teenager. Dr. Kilduff was the PhD who oversaw the paper she submitted. Ms. Blewett earned a scholarship to Harvard; she was a senior in 2014.
PUBLIC RELEASE: 4-MAR-2010
Researchers find further evidence linking Epstein-Barr virus and risk of multiple sclerosis
First long-term study among individuals not infected with EBV suggests EBV infection likely to be a cause of MS, not a consequence HARVARD SCHOOL OF PUBLIC HEALTH
I hope this is helpful and inspires all to think outside the MS box.
Lisa Torrey
Abstracts & Articles
Zh Nevrol Psikhiatr Im S S Korsakova. 2011;111(7):8-12.
[Differential aspects of multiple sclerosis and chronic borrelial encephalomyelitis].
[Article in Russian]
Spirin NN, Baranova NS, Fadeeva OA, Shipova EG, Stepanov IO.
Abstract
The Yaroslavl region is an endemic area for Lyme disease (LD) with one of the highest levels of morbidity in Russia. Chronic neuroborreliosis can mimic multiple sclerosis and cause considerable difficulties in differential diagnosis. A comparative clinical-instrumental analysis of patients with definite multiple sclerosis (n=65) and chronic borrelial encephalomyelitis (n=11) was carried out. The key differential-diagnostic features of multiple sclerosis and borrelial encephalomyelitis were specified. Migrating erythema and tick's bite in the anamnesis, combined with lesions of the central and peripheral nervous systems, the absence of retrobulbar neuritis in the anamnesis, artralgia and myalgia, the high blood sedimentation rate were not characteristic of multiple sclerosis. A patient with abovementioned findings should be tested for the presence of antibodies to Borrelia burgdorferi in the blood serum and, if necessary, in the cerebrospinal fluid to exclude the diagnosis of Lime disease.
PMID: 21947065 [PubMed - indexed for MEDLINE]
Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(2 Pt 2):64-8.
[Lyme disease in patients with multiple sclerosis: clinical, diagnostic and therapeutic features].
[Article in Russian]
Baranova NS, Spirin NN, Fadeeva OA, Shipova EG, Stepanov IO.
Abstract
Lyme disease is one of the most frequent infections in the Russian Federation. In patients with multiple sclerosis, the Borrelia infection may act as a trigger in some cases and also worsens the clinical course of multiple sclerosis. One hundred patients with definite multiple sclerosis were examined including 19 patients with the combination of multiple sclerosis and Lyme disease. The difficulties of diagnosis, clinical features and treatment of Lyme disease in patients with multiple sclerosis are discussed.
PMID: 22677681 [PubMed - indexed for MEDLINE]
Zh Nevrol Psikhiatr Im S S Korsakova. 2012;112(9 Pt 2):34-9.
[Differential diagnosis of late-stage neuroborreliosis with affection of the central nervous system].
[Article in Russian]
Spirin NN, Baranova NS, Fadeeva OA, Pakhomova IuA, Stepanov IO, Shipova EG, Kasatkin DS, Spirina NN.
Abstract
Chronic neuroborreliosis is an actual problem in neurology due to its under-investigation in Russia, variety of clinical forms, and the absence of well established diagnostic criteria. We present clinical and laboratory differential diagnostic criteria of chronic borrelial encephalomyelitis in comparison with multiple sclerosis. Distinguishing characteristics of Lyme encephalopathy versus vascular encephalopathy are considered. Problems and possibilities of immunological methods for identification of B. burgdorferi are discussed. The results of the antibiotic treatment of different clinical forms of neuroborreliosis with affection of the central nervous system are described.
PMID: 23235422 [PubMed - indexed for MEDLINE]
Med Hypotheses. 2007;69(1):117-9. Epub 2007 Jan 2.
Lyme borreliosis and multiple sclerosis are associated with primary effusion lymphoma.
Batinac T1, Petranovic D, Zamolo G, Petranovic D, Ruzic A.
- 1Department of Dermatovenerology, Rijeka University Hospital, Kresimirova 42, 51000 Rijeka, Croatia.
Abstract
Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by chronic inflammation and demyelination. Studies suggested that the viral, especially Epstein-Barr virus infection, and bacterial infections, especially Borrelia burgdorferi infection, play a role in etiology of MS. MS prevalence parallels the distribution of the Lyme disease pathogen B. burgdorferi. Criteria used for diagnosis of MS can also be fulfilled in other conditions such as Lyme disease, a multisystem disorder resulting from infection by the tick-borne spirochete, B. burgdorferi. In the late period of Lyme disease demyelinating involvement of central nervous system can develop and MS can be erroneously diagnosed. A Lyme borreliosis can mimick central nervous system lymphoma. Also, B. burgdorferi has been implicated not only in etiology of MS, but also in etiology of lymphoma. Studies suggested that there is an increased risk of non-Hodgkin lymphoma in patients, who had a history of autoimmune diseases such as MS and that both non-Hodgkin's lymphomas and Hodgkin's disease were associated with Epstein-Barr virus infection. A small group of lymphomas called primary effusion lymphomas (PEL) is a recently individualized form of non-Hodgkin's lymphoma (WHO classification) that exhibit exclusive or dominant involvement of serous cavities, without a detectable solid tumor mass. These lymphomas have also been linked to Epstein-Barr virus and human herpes virus type 8 infections but virus negative cases have been described. Therefore, we propose that MS and neuroborreliosis are linked to central nervous system primary effusion lymphomas. As a first step in confirming or refuting our hypotheses, we suggest a thorough study of CSF in the patients suspected for the diagnosis of MS and Lyme borreliosis.
PMID: 17197115 [PubMed - indexed for MEDLINE]
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Neurology. 2013 Sep 10;81(11):1012-4. doi: 10.1212/WNL.0b013e3182a43b66. Epub 2013 Jul 26.
Neuroborreliosis during natalizumab treatment in multiple sclerosis.
Thomas K1, Schultheiss T, Ziemssen T.
- 1From the MS Center, Center of Clinical Neuroscience, Neurological University Clinic Dresden, University Clinic Carl Gustav Carus Dresden, University of Technology Dresden, Germany.
Abstract
We present a case of acute neuroborreliosis in the setting of long-term treatment with natalizumab. A 33-year-old man was diagnosed with relapsing-remitting multiple sclerosis (MS) in 1999. Following failure of various immunomodulatory treatments including interferon and immunoglobulin, he was treated with mitoxantrone from May 2000 to August 2004. Due to persistently high disease activity, he was also treated with cyclophosphamide (December 2005-April 2006) and then azathioprine (April-June 2006), which were both discontinued due to adverse effects. After the patient scored 6.5 on the Expanded Disability Status Scale and had 2 relapses in 2006, we initiated natalizumab therapy (300 mg monthly, starting September 2006). The patient improved significantly in ambulation and the relapse rate slowed as well.
PMID: 23892705 [PubMed - indexed for MEDLINE]
Neuropediatrics. 2013 Dec;44(6):302-8. doi: 10.1055/s-0033-1358599. Epub 2013 Oct 28.
Rare inflammatory diseases of the white matter and mimics of multiple sclerosis and related disorders.
- 1Department of Pediatric Neurology, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
Abstract
The spectra of white matter neuroinflammatory diseases and pathological processes inducing inflammatory lesions in the white matter of the central nervous system are wider in children than in adults. The definitions of multiple sclerosis (MS) and of the related clinically isolated syndromes (CIS) and acute disseminated encephalomyelitis (ADEM) have been recently revised leading to a new consensus definition. However, other entities with similarities to these diseases may also develop with monophasic or relapsing white matter inflammation. These conditions include congenital immunogenetic diseases (such as hemophagocytic lymphohistiocytosis), vasculitis, and autoantibody-mediated encephalopathies (Hashimoto encephalopathy, encephalitis with anti-N-methyl-D-aspartate receptor antibodies and neuromyelitis optica). Moreover, infectious diseases, such as Lyme disease, tumors (oligodendroglioma and lymphoma), and even genetic or metabolic diseases should also be considered if the clinical course of the disease does not follow the typical pattern for ADEM or MS. This short review describes these different entities and provides information for the differential diagnosis of inflammatory diseases of the white matter.
Georg Thieme Verlag KG Stuttgart · New York.
PMID: 24166147 [PubMed - indexed for MEDLINE]
Neuropediatrics. 2013 Dec;44(6):302-8. doi: 10.1055/s-0033-1358599. Epub 2013 Oct 28.
Rare inflammatory diseases of the white matter and mimics of multiple sclerosis and related disorders.
Abstract
The spectra of white matter neuroinflammatory diseases and pathological processes inducing inflammatory lesions in the white matter of the central nervous system are wider in children than in adults. The definitions of multiple sclerosis (MS) and of the related clinically isolated syndromes (CIS) and acute disseminated encephalomyelitis (ADEM) have been recently revised leading to a new consensus definition. However, other entities with similarities to these diseases may also develop with monophasic or relapsing white matter inflammation. These conditions include congenital immunogenetic diseases (such as hemophagocytic lymphohistiocytosis), vasculitis, and autoantibody-mediated encephalopathies (Hashimoto encephalopathy, encephalitis with anti-N-methyl-D-aspartate receptor antibodies and neuromyelitis optica). Moreover, infectious diseases, such as Lyme disease, tumors (oligodendroglioma and lymphoma), and even genetic or metabolic diseases should also be considered if the clinical course of the disease does not follow the typical pattern for ADEM or MS. This short review describes these different entities and provides information for the differential diagnosis of inflammatory diseases of the white matter.
Georg Thieme Verlag KG Stuttgart · New York.
PMID: 24166147 [PubMed - in process]
AJNR Am J Neuroradiol. 2009 Jun;30(6):1079-87. doi: 10.3174/ajnr.A1579. Epub 2009 Apr 3.
Lyme neuroborreliosis: manifestations of a rapidly emerging zoonosis.
Hildenbrand P1, Craven DE, Jones R, Nemeskal P.
- 1Department of Radiology, Lahey Clinic Medical Center, Burlington, MA 01805, USA. Hildenbrand@lahey.org
Abstract
Lyme disease has a worldwide distribution and is the most common vector-borne disease in the United States. Incidence, clinical manifestations, and presentations vary by geography, season, and recreational habits. Lymeneuroborreliosis (LNB) is neurologic involvement secondary to systemic infection by the spirochete Borrelia burgdorferi in the United States and by Borrelia garinii or Borrelia afzelii species in Europe. Enhanced awareness of the clinical presentation of Lyme disease allows inclusion of LNB in the imaging differential diagnosis of facial neuritis, multiple enhancing cranial nerves, enhancing noncompressive radiculitis, and pediatric leptomeningitis with white matter hyperintensities on MR imaging. The MR imaging white matter appearance of successfully treated LNB and multiple sclerosis display sufficient similarity to suggest a common autoimmune pathogenesis for both. This review highlights differences in the epidemiology, clinical manifestations, diagnosis, and management of Lyme disease in the United States, Europe, and Asia, with an emphasis on neurologic manifestations and neuroimaging.
PMID: 19346313 [PubMed - indexed for MEDLINE] Free full text
Neurology. 2013 Sep 10;81(11):1012-4. doi: 10.1212/WNL.0b013e3182a43b66. Epub 2013 Jul 26.
Neuroborreliosis during natalizumab treatment in multiple sclerosis.
Thomas K, Schultheiss T, Ziemssen T.
Abstract
We present a case of acute neuroborreliosis in the setting of long-term treatment with natalizumab. A 33-year-old man was diagnosed with relapsing-remitting multiple sclerosis (MS) in 1999. Following failure of various immunomodulatory treatments including interferon and immunoglobulin, he was treated with mitoxantrone from May 2000 to August 2004. Due to persistently high disease activity, he was also treated with cyclophosphamide (December 2005-April 2006) and then azathioprine (April-June 2006), which were both discontinued due to adverse effects. After the patient scored 6.5 on the Expanded Disability Status Scale and had 2 relapses in 2006, we initiated natalizumab therapy (300 mg monthly, starting September 2006). The patient improved significantly in ambulation and the relapse rate slowed as well.
PMID: 23892705 [PubMed - indexed for MEDLINE]
Acta Neurol Scand. 2011 Jun;123(6):396-9. doi: 10.1111/j.1600-0404.2010.01411.x.
Multiple sclerosis in Vest-Agder County, Norway.
Vatne A, Mygland A, Ljøstad U.
Abstract
To examine multiple sclerosis (MS) prevalence, rate of immunomodulatory treatment and frequency of Borrelia burgordorferi (Bb) antibodies in Vest-Agder, Norway.
Patients in the period 1996-2006 who met the Poser criteria for definitive or probable MS were included. Clinical and demographical data, and presence of Bb antibodies were registered.
A total of 295 patients were identified. The crude prevalence was 180 per 100,000 population (95% CI=160.9-218.0), age-adjusted prevalence was 186 per 100,000 population (95% CI=166.3-225.3). The age-adjusted incidence rates were 7.5 and 8.0 for 1996-2000 and 2001-2006, respectively. Thirty-eight per cent were treated with immunomodulatory agents when compared to 28% in the rest of the country. Bb serum antibodies were detected in 7% of patients with MS.
Vest-Agder county has the highest prevalence of MS reported in Norway, and a high treatment rate. Bb antibodies were not more prevalent than in healthy individuals.
© 2010 John Wiley & Sons A/S.
PMID: 21492097 [PubMed - indexed for MEDLINE]
Clin Neurol Neurosurg. 2010 Sep;112(7):625-8. doi: 10.1016/j.clineuro.2010.04.011. Epub 2010 May 2.
Rare infections mimicking MS.
- 1University of Zagreb, School of Medicine and University Hospital Centre Zagreb, Department of Neurology and Refferal Center for Demyelinating Diseases of the Central Nervous System, Zagreb, Croatia. vesna.brinar@zg.t-com.hr
Abstract
The diagnosis of multiple sclerosis (MS), despite well defined clinical criteria is not always simple. On many occasions it is difficult to differentiate MS from various non-MS idiopathic demyelinating disorders, specific and infectious inflammatory diseases or non-inflammatory demyelinating diseases. Clinicians should be aware of various clinical and MRI "red flags" that may point to the other diagnosis and demand further diagnostic evaluation. It is generally accepted that atypical clinical symptoms or atypical neuroimaging signs determine necessity for broad differential diagnostic work up. Of the infectious diseases that are most commonly mistaken for MS the clinician should take into account Whipple's disease, Lyme disease, Syphilis, HIV/AIDS, Brucellosis, HHV-6 infection, Hepatitis C, Mycoplasma and Creutzfeld-Jacob disease, among others. Cat scratch disease caused by Bartonella hensellae, Mediterranean spotted fever caused by Riketssia connore and Leptospirosis caused by different Leptospira serovars rarely cause focal neurological deficit and demyelinating MRI changes similar to MS. When atypical clinical and neuroimaging presentations are present, serology on rare infectious diseases that may mimic MS may be warranted. This review will focus on the infectious diseases mimicking MS with presentation of rare illustrative cases.
Comment in
- 'Rare' infections mimicking multiple sclerosis: consider Lyme disease. [Clin Neurol Neurosurg. 2011]
PMID: 20439131 [PubMed - indexed for MEDLINE]
Clin Neurol Neurosurg. 2010 Sep;112(7):625-8. doi: 10.1016/j.clineuro.2010.04.011. Epub 2010 May 2.
Rare infections mimicking MS.
Abstract
The diagnosis of multiple sclerosis (MS), despite well defined clinical criteria is not always simple. On many occasions it is difficult to differentiate MS from various non-MS idiopathic demyelinating disorders, specific and infectious inflammatory diseases or non-inflammatory demyelinating diseases. Clinicians should be aware of various clinical and MRI "red flags" that may point to the other diagnosis and demand further diagnostic evaluation.
It is generally accepted that atypical clinical symptoms or atypical neuroimaging signs determine necessity for broad differential diagnostic work up.
Of the infectious diseases that are most commonly mistaken for MS the clinician should take into account Whipple's disease, Lyme disease, Syphilis, HIV/AIDS, Brucellosis, HHV-6 infection, Hepatitis C, Mycoplasma and Creutzfeld-Jacob disease, among others. Cat scratch disease caused by Bartonella hensellae, Mediterranean spotted fever caused by Riketssia connore and Leptospirosis caused by different Leptospira serovars rarely cause focal neurological deficit and demyelinating MRI changes similar to MS. When atypical clinical and neuroimaging presentations are present, serology on rare infectious diseases that may mimic MS may be warranted. This review will focus on the infectious diseases mimicking MS with presentation of rare illustrative cases.
Comment in
- 'Rare' infections mimicking multiple sclerosis: consider Lyme disease. [Clin Neurol Neurosurg. 2011]
PMID: 20439131 [PubMed - indexed for MEDLINE]
OBJECTIVE:
MATERIALS AND METHODS:
RESULTS:
CONCLUSIONS:
Med Hypotheses. 2005;64(3):438-48.
Chronic Lyme borreliosis at the root of multiple sclerosis--is a cure with antibiotics attainable?
- 1Clinic for Internal and Geographical Medicine, Soodstrasse 13, 8134 Adliswil, Switzerland. markus.fritzsche@gmx.ch
Abstract
Apart from its devastating impact on individuals and their families, multiple sclerosis (MS) creates a huge economic burden for society by mainly afflicting young adults in their most productive years. Although effective strategies for symptom management and disease modifying therapies have evolved, there exists no curative treatment yet. Worldwide, MS prevalence parallels the distribution of the Lyme disease pathogen Borrelia (B.) burgdorferi, and in America and Europe, the birth excesses of those individuals who later in life develop MS exactly mirror the seasonal distributions of Borrelia transmitting Ixodes ticks. In addition to known acute infections, no other disease exhibits equally marked epidemiological clusters by season and locality, nurturing the hope that prevention might ultimately be attainable. As minocycline, tinidazole and hydroxychloroquine are reportedly capable of destroying both the spirochaetal and cystic L-form of B. burgdorferi found in MS brains, there emerges also new hope for those already afflicted. The immunomodulating anti-inflammatory potential of minocycline and hydroxychloroquine may furthermore reduce the Jarisch Herxheimer reaction triggered by decaying Borrelia at treatment initiation. Even in those cases unrelated to B. burgdorferi, minocycline is known for its beneficial effect on several factors considered to be detrimental in MS. Patients receiving a combination of these pharmaceuticals are thus expected to be cured or to have a longer period of remission compared to untreated controls. Although the goal of this rational, cost-effective and potentially curative treatment seems simple enough, the importance of a scientifically sound approach cannot be overemphasised. A randomised, prospective, double blinded trial is necessary in patients from B. burgdorferi endemic areas with established MS and/or Borrelia L-forms in their cerebrospinal fluid, and to yield reasonable significance within due time, the groups must be large enough and preferably taken together in a multi-centre study.
PMID: 15617845 [PubMed - indexed for MEDLINE]
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Przegl Epidemiol. 2006;60 Suppl 1:39-45.
[Multifocal central nervous system lesions --multiple sclerosis or neuroborreliosis?].
[Article in Polish]
- 1Klinika Neurologii AM w Białymstoku.
Abstract
Multiple sclerosis is the most frequent multifocal disease of the central nervous system, but in a diagnosis of atypical cases about 100 other diseases should be considered. Neuroborreliosis plays a particular role among them, especially in endemic regions. Difficulties result from similarities of clinical symptoms and lack of specific diagnostic investigations. Diagnostic procedures in neuroborreliosis are mostly based on laboratory analyses and serologic examinations of serum and cerebrospinal fluid, in connection with a clinical picture and an epidemiological state. Since the year 2001, multiple sclerosis neurological diagnostic is based on the diagnostic criteria established under the auspices of The US National Multiple Sclerosis Society and International Federation of Multiple Sclerosis Societies. Those recommendations regarding relapsing-remitting MS and primary progressing MS are discussed in this paper. Current knowledge of those diseases warrants cautiousness in the diagnostic of atypical cases.
PMID: 16909774 [PubMed - indexed for MEDLINE]
Adv Nurse Pract. 2005 Sep;13(9):20.
Neuralgia and demyelinating plaques: MS or lyme disease?
Savely G1.
- 1South Austin Family Practice Clinic, Austin, Texas, USA.
PMID: 16152811 [PubMed - indexed for MEDLINE]
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Acta Neurol Scand. 2005 Aug;112(2):97-102.
Relevance of immunological variables in neuroborreliosis and multiple sclerosis.
Bednárová J, Stourac P, Adam P.
- Department of Clinical Microbiology, Faculty Hospital, Masaryk University, Brno, Czech Republic.
Abstract
The aims were to investigate the frequency of intrathecal synthesis of specific antibodies against measles (M), rubella (R) and varicella zoster (Z) viruses (MRZ reaction) as a diagnostic marker between multiple sclerosis (MS) and neuroborreliosis (NB) groups and to postulate the most typical cerebrospinal fluid (CSF) variables profile of these entities.
Three cohorts of patients were investigated: MS (n = 42), NB (n = 27) and other neurological diseases (OND) (n = 15). Measles, rubella, varicella zoster and borrelia-specific IgG antibodies were measured by ELISA, Q(alb) (CSF/serum albumin ratio) as a marker of blood-CSF barrier function and specific antibody indices (AI) were calculated according to relevant formulae. IgG oligoclonal bands (OB) were detected by isoelectric focusing and immunoenzymatic staining.
Eighty-eight percent of MS patients had positive MRZ reaction and 26.2% had positive anti-borrelia AI. Eighty-nine percent of NB patients had positive anti-borrelia AI and two patients had individually anti-measles and rubella positive AI. MS-CSF variables profile included the presence of IgG OB in 81%, elevated Q(alb) in 31% and normal cell count in 66.7%. Of NB patients IgG OB were positive in 74%, elevated Q(alb) in 81.5% and normal cell count in 7.4%.
MRZ reaction was proved as statistically significant marker in differential diagnosis between MS and NB. Typical CSF variables profile of these two entities is highly supportive, especially when MRZ is included.
PMID: 16008535 [PubMed - indexed for MEDLINE]
Med Hypotheses. 2005;64(3):438-48.
Chronic Lyme borreliosis at the root of multiple sclerosis--is a cure with antibiotics attainable?
- Clinic for Internal and Geographical Medicine, Soodstrasse 13, 8134 Adliswil, Switzerland. markus.fritzsche@gmx.ch
Abstract
Apart from its devastating impact on individuals and their families, multiple sclerosis (MS) creates a huge economic burden for society by mainly afflicting young adults in their most productive years. Although effective strategies for symptom management and disease modifying therapies have evolved, there exists no curative treatment yet.
Worldwide, MS prevalence parallels the distribution of the Lyme disease pathogen Borrelia (B.) burgdorferi, and in America and Europe, the birth excesses of those individuals who later in life develop MS exactly mirror the seasonal distributions of Borrelia transmitting Ixodes ticks.
In addition to known acute infections, no other disease exhibits equally marked epidemiological clusters by season and locality, nurturing the hope that prevention might ultimately be attainable. As minocycline, tinidazole and hydroxychloroquine are reportedly capable of destroying both the spirochaetal and cystic L-form of B. burgdorferi found in MS brains, there emerges also new hope for those already afflicted.
The immunomodulating anti-inflammatory potential of minocycline and hydroxychloroquine may furthermore reduce the Jarisch Herxheimer reaction triggered by decaying Borrelia at treatment initiation. Even in those cases unrelated to B. burgdorferi, minocycline is known for its beneficial effect on several factors considered to be detrimental in MS.
Patients receiving a combination of these pharmaceuticals are thus expected to be cured or to have a longer period of remission compared to untreated controls. Although the goal of this rational, cost-effective and potentially curative treatment seems simple enough, the importance of a scientifically sound approach cannot be overemphasised.
A randomised, prospective, double blinded trial is necessary in patients from B. burgdorferi endemic areas with established MS and/or Borrelia L-forms in their cerebrospinal fluid, and to yield reasonable significance within due time, the groups must be large enough and preferably taken together in a multi-centre study.
PMID: 15617845 [PubMed - indexed for MEDLINE]
Eur J Neurol. 2004 Aug;11(8):525-9.
CSF isoelectrofocusing in a large cohort of MS and other neurological diseases.
Bourahoui A, De Seze J, Guttierez R, Onraed B, Hennache B, Ferriby D, Stojkovic T, Vermersch P.
Abstract
The present study was performed in order to confirm the diagnostic value of isoelectrofocusing (IEF) in a large multiple sclerosis (MS) cohort and to evaluate the various neurological diseases probably to present a similar IEF profile. The cerebrospinal fluid (CSF) of 1292 patients with neurological diseases was studied by IEF.
After a follow-up of 2-36 months, we only included patients with a definite MS or confirmed diagnosis of other neurological diseases (OND). MS was diagnosed in 407 patients and OND in 593 patients. For patients in whom three or more oligoclonal bands (OCB) were detected, IEF results showed a sensitivity of 85% and a specificity of 92% for the diagnosis of MS.
The positive and negative predictive values were 86.5 and 90%, respectively. Inflammatory and infectious disorders of the central nervous system represented the main affections associated with OCB, including human immunodeficiency virus encephalitis, Lyme disease and less frequently Sjogren syndrome.
Furthermore, when OCB were observed, 10 or more bands were more frequently found in MS than in OND (P < 0.0001). IEF of the CSF is a reliable method for the diagnosis of MS. The absolute number of bands may help to discriminate between MS and OND.
PMID: 15272896 [PubMed - indexed for MEDLINE]
Additional Studies
Fritz CL, Kjemtrup AM.
J Am Vet Med Assoc. 2003 Nov 1;223(9):1261-70. Review.
Quorum sensing by the Lyme disease spirochete.
PMID: 14621212 [PubMed - indexed for MEDLINE]
Stevenson B, von Lackum K, Wattier RL, McAlister JD, Miller JC, Babb K.
Microbes Infect. 2003 Sep;5(11):991-7. Review.
A newly discovered cholesteryl galactoside from Borrelia burgdorferi.
PMID: 12941391 [PubMed - indexed for MEDLINE]
Ben-Menachem G, Kubler-Kielb J, Coxon B, Yergey A, Schneerson R.
Proc Natl Acad Sci U S A. 2003 Jun 24;100(13):7913-8. Epub 2003 Jun 10.
Immunological and genetic characterization of Borrelia burgdorferi BapA and EppA proteins.
PMID: 12799465 [PubMed - indexed for MEDLINE] Free PMC Article
Miller JC, Stevenson B.
Microbiology. 2003 May;149(Pt 5):1113-25.
PMID: 12724373 [PubMed - indexed for MEDLINE] Free Article
Christova I, Tasseva E, Stamenov B, Sabev K.
Int J Immunopathol Pharmacol. 2000 May-Aug;13(2):99-106.
Geographical and seasonal correlation of multiple sclerosis to sporadic schizophrenia.
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Fritzsche M.
Int J Health Geogr. 2002 Dec 20;1(1):5.
PMID: 12537588 [PubMed - as supplied by publisher] Free PMC Article
Huang D, Tani M, Wang J, Han Y, He TT, Weaver J, Charo IF, Tuohy VK, Rollins BJ, Ransohoff RM.
J Neurosci. 2002 Dec 15;22(24):10633-42.
[The laboratory diagnosis of multiple sclerosis].
PMID: 12486156 [PubMed - indexed for MEDLINE] Free Article
Brinar VV, Pozer ChM.
Zh Nevrol Psikhiatr Im S S Korsakova. 2002;Suppl:7-14. Russian.
[New aspects of the pathogenesis of lyme disease].
PMID: 12418386 [PubMed - indexed for MEDLINE]
Zajkowska JM, Hermanowska-Szpakowicz T.
Przegl Epidemiol. 2002;56 Suppl 1:57-67. Review. Polish.
Cerebrospinal fluid affects phenotype and functions of myeloid dendritic cells.
PMID: 12194230 [PubMed - indexed for MEDLINE]
Pashenkov M, Söderström M, Huang YM, Link H.
Clin Exp Immunol. 2002 May;128(2):379-87.
Characterization of the P13 membrane protein of Borrelia burgdorferi by mass spectrometry.
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Nilsson CL, Cooper HJ, Håkansson K, Marshall AG, Ostberg Y, Lavrinovicha M, Bergström S.
J Am Soc Mass Spectrom. 2002 Apr;13(4):295-9.
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Trojano M, Paolicelli D.
Neurol Sci. 2001 Nov;22 Suppl 2:S98-102. Review.
Differential diagnosis of posterior fossa multiple sclerosis lesions--neuroradiological aspects.
PMID: 11794488 [PubMed - indexed for MEDLINE]
Falini A, Kesavadas C, Pontesilli S, Rovaris M, Scotti G.
Neurol Sci. 2001 Nov;22 Suppl 2:S79-83. Review.
FLAIR and magnetization transfer imaging of patients with post-treatment Lymedisease syndrome.
PMID: 11794484 [PubMed - indexed for MEDLINE]
Morgen K, Martin R, Stone RD, Grafman J, Kadom N, McFarland HF, Marques A.
Neurology. 2001 Dec 11;57(11):1980-5.
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Martin R, Gran B, Zhao Y, Markovic-Plese S, Bielekova B, Marques A, Sung MH, Hemmer B, Simon R, McFarland HF, Pinilla C.
J Autoimmun. 2001 May;16(3):187-92. Review.
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Dev Biol (Basel). 2000;103:61-7.
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J Pediatr Ophthalmol Strabismus. 2000 Sep-Oct;37(5):254-9.
Chorea as a symptom of neuroborreliosis: a case study.
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Electrophoresis. 1999 Dec;20(18):3611-22.
Proteomics in human disease: cancer, heart and infectious diseases.
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OBJECTIVES:
METHODS:
RESULTS:
CONCLUSION:
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