MS- Multiple Sclerosis

Multiple Sclerosis


Typically, the more your doctor resists checking into Lyme disease as the cause of your symptoms, the more patients he or she realizes they've misdiagnosed over the years. 

If you've been diagnosed with MS please do yourself a favor now and completely exhaust all possibilities that it could be Lyme and or other tick borne infections before settling on the MS (no known cause, no known cure) diagnosis.  If you entertain the MS diagnosis without questioning it and find out later it might be Lyme, you can't unpaint that wall.  The damage will have been done.  

In your search for answers please remember up to 75% of people with Lyme disease test negative on Lyme tests.  Once you have a diagnosis of MS by a doctor, it is a rare day that same doctor will advocate for you or assist you in your quest to find different answers for fear of legal actions being brought against them.     

Dr. Lis Heininger (NY), originally diagnosed with MS, advocated for better research and education on the disease that so greatly affected her life.  It wasn't until much later she learned she actually had chronic Lyme disease.  The Lyme disease could have been properly treated with a better outcome for both Lis and her family had it been detected sooner.  Click here to read about Lis.  

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July 2016 Article

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List of Multiple Sclerosis & Neuroborreliosis Articles

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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:

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-2010Researchers 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

 

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Is MS Really Lyme Disease?


Bentz Joel S MD, Laboratory Investigation of Multiple Sclerosis. Laboratory Medicine June 1995;26(6):393-399

Coyle PK. Borrelia burgdorferi antibodies in Multiple sclerosis patients. Neurology 1989;39:760-761

Coyle PK, Krupp LB, Doscher C. Significance of reactive Lyme Serology in Multiple Sclerosis. Ann Neurol 1993;34(5)745-7

Cruz M, Olssson T, Ernerudh J, et al. Immunoblot detection of oligoclonal antimyelin basic protein IgG antibodies in the cerebrospinal fluid of Multiple Sclerosis patients. Neurology 1987;37:1515-1519

Hillert J. HLA Class II associated genetic susceptibility in Multiple Sclerosis: A critical evaluation of tissue antigens. 1991 handout. 

Kepes John K M.D. Large focal tumor-like demyelinating lesions of the brain: Intermediate entity between Multiple sclerosis and acute disseminated encephalomyelitis? A study of 31 patients. Ann Neurol 1993;33:18-27

Multiple sclerosis and Dogs (Letter) Lancet February 26, 1977: pp 487

Marshall V. Multiple Sclerosis is a Chronic Central Nervous System Infection by a Spirochetal Agent. Medical Hypothesis 1988;25:89-92

Schmutzhard E, Pohl P, Stanek G. Borrelia burgdorferi antibodies in patients with relapsing/remitting form and chronic progressive form of multiple sclerosis. 
J Neurol Neurosurg Psych 1988;51:1215-1218

VanHeerde DJ M.D., Grier TM, Jones BJ. Lyme Endemic Area Multiple Sclerosis Study. A study of MS patients in three counties highly endemic for both Lyme disease and MS. (Pine county, St. Louis County, Carlton County.) MS patients seronegative for Lyme are treated with antibiotics and urine is tested for Lyme antigens. August 1993 on going study un-published data.  

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Dr. Alan MacDonald discusses huge impact to millions of lives of sufferers of ALS, Parkinson's, Alzheimer's, & MS in a clip from the documentary "Under Our Skin". He subsequently goes on to prove the existence of Borrelia spirochetes (Lyme Disease) in 100% of Alzheimer's brains & finds new spirochetes that cause Lyme Disease in Alzheimer's brains as well as filarial worms in BOTH Alzheimer's brains & MS samples. His next quest is for Borrelia in MS patients.

https://www.youtube.com/watch?v=44xL0z8I5X8 

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Lyme Disease (Borrelia bacteria) & filarial nematodes found in Alzheimer's patients (both transmitted by ticks). Now filarial worms have been found in MS too. Both Borrelia & filarial worms are transmitted via a tick bite.

http://f1000research.com/posters/5-79 

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http://www.mms-seminar.com/wp-content/uploads/2015/08/2001-norway-brorson-ms-is-lyme.pdf 

http://www.ncbi.nlm.nih.gov/pubmed/15617845 

http://pubs.rsna.org/doi/full/10.1148/radiol.2531081103 

http://www.dailymail.co.uk/health/article-2343062/Mother-diagnosed-MS-facing-life-wheelchair-cured--discovered-symptoms-TICK-BITE.html 

http://myhealthsecrets.website/?p=2288 

http://issuesoncall.blogspot.com/2007/12/ms-parkinsons-or-simply-lyme-disease.html

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Lyme vs MS from Dr. Susan Marra...Borrelia Lyme Disease spirochetes love fatty acids in brains & neurons. Hmmmm & hence the association in multiple labeled disease with Lyme disease. Alzheimer's/Dementia, MS, Parkinson's, & ALS are all brain & neuron disease. All areas which Borrelia spirochete bacteria LOVE!!!!

https://www.youtube.com/watch?v=iefwOpP-EiM 

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Billionaire John Caudwell mentions huge Borreliosis issues globally & mentions ALS, Parkinson's, Alzheimer's, & MS.
https://www.youtube.com/watch?v=Y24QL-H5ZLU

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https://sites.google.com/site/marylandlyme/lyme/ms--multiple-sclerosis


The above collection was assembled and shared by Lymedin2010, a member of LymeNet.

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Selected 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 NNBaranova NSFadeeva OAShipova EGStepanov 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 NSSpirin NNFadeeva OAShipova EGStepanov 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 NNBaranova NSFadeeva OAPakhomova IuAStepanov IOShipova EGKasatkin DSSpirina 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 DZamolo GPetranovic DRuzic A.

Author information

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] 

 

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 TZiemssen T.

Author information

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.

Tardieu M1, Deiva K.

Author information

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.

Tardieu MDeiva K.

Author information

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 DEJones RNemeskal P.

Author information

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 KSchultheiss TZiemssen T.

Author information

 

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 AMygland ALjøstad U.

Author information

Abstract

OBJECTIVE:

To examine multiple sclerosis (MS) prevalence, rate of immunomodulatory treatment and frequency of Borrelia burgordorferi (Bb) antibodies in Vest-Agder, Norway.

MATERIALS AND METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

Brinar VV1, Habek M.

Author information

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.

Brinar VVHabek M.

Author information

 

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]

 

Med Hypotheses. 2005;64(3):438-48.

Chronic Lyme borreliosis at the root of multiple sclerosis--is a cure with antibiotics attainable?

Fritzsche M1.

Author information

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] 

  

Przegl Epidemiol. 2006;60 Suppl 1:39-45.

[Multifocal central nervous system lesions --multiple sclerosis or neuroborreliosis?].

[Article in Polish]

Drozdowski W1.

Author information

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.

Author information

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 JStourac PAdam P.

Author information

Department of Clinical Microbiology, Faculty Hospital, Masaryk University, Brno, Czech Republic.

Abstract

OBJECTIVES:

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.

METHODS:

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.

RESULTS:

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%.

CONCLUSION:

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?

Fritzsche M.

Author information

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 ADe Seze JGuttierez ROnraed BHennache BFerriby DStojkovic TVermersch P.

Author information

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]

 


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