Panic Attacks Can Alert Psychiatrists To Suspect Lyme Encephalopathy

Panic Attacks Can Alert Psychiatrists

To Suspect Lyme Encephalopathy

In a Pennsylvania psychiatric office within a mid-winter, 1999 ten-week span, three nurses individually presented with severe panic attacks. Previously "nerveless", they suddenly and separately, experienced episodes of racing pulse, breathlessness, overwhelming anxiety, impending doom, sweating, unique pains, headaches, chills and confusion. Family doctors eliminated other etiologies, reassuring them they had typical panic disorders.

Subsequent evaluation by the psychiatrist included testing for tick-borne diseases (TBD).(1) Results, utilizing sensitive tests via several reference laboratories, included no positive Lyme serologies but positive polymerase chain reactions of blood (2 cases) or urine (1 case) for DNA of Lyme spirochetes and positive SPECT brain scans indicating encephalopathies compatible with Lyme disease in all 3 cases.

Currently, all 3 women are free of panic attacks while taking high oral doses of appropriate antimicrobial medications for their infections--primarily Lyme borreliosis.(2) Anxiolytics became unnecessary in one case and were greatly reduced in the others. Two patients require pain medications for other symptoms of persistent Lyme disease. Since the RNs' diagnoses, others in the same geographic area also have been diagnosed as having Lyme encephalitis/vasculitis via SPECT scans including one seronegative man who experienced horrific rage/panics/headaches but who is recovering via antimicrobial treatment for previously unsuspected TBD.

By Virginia T. Sherr, MD

03/01/02

References:

1. Fallon BA: Psychiatric aspects of Lyme disease.

Psychiatric Clinics of North America. 1999; 154: 1625-29

2. Logigian EL et al: Reversible cerebral hypoperfusion in Lyme encephalopathy.

Neurology. 1997; 49: 1661-1670