Acute transverse myelitis – A rare clinical manifestation of Lyme neuroborreliosis.
Acute transverse myelitis (ATM) is a rare, potentially devastating neurological syndrome that has variety of causes, infectious being one of them. Lyme disease (LD) is the most common vector borne zoonosis in the United States (U.S.). While neurologic complications of LD are common, acute transverse myelitis is an exceedingly rare complication.
We present a case of a previously healthy 25-year-old man who presented with secondary erythema migrans, aseptic meningitis and clinical features of transverse myelitis including bilateral lower extremity motor and sensory deficits manifesting as weakness and numbness, urinary retention and constipation.
Despite negative serum antibodies against Borrelia burgdoferi, cerebrospinal fluid (CSF) was positive for Borrelia burgdorferi PCR.
Following treatment with methylprednisolone and ceftriaxone, he attained complete recovery apart from neurogenic bladder necessitating intermittent self-catheterization. We report rare manifestation of a common disease and emphasize the importance of considering LD in the differential diagnosis of acute transverse myelitis, particularly in residents of endemic areas.
Nobody has a CLUE about how often anything is occurring in Lyme/MSIDS, when testing misses over half of all cases and folks are commonly misdiagnosed or undiagnosed for years. Again, because words mean things, and research has been used against patients for over 40 years, a more accurate statement would be, “This is the first recorded case of ATM caused by Lyme Disease.” And remember, just because something isn’t on record doesn’t mean it hasn’t happened. Important distinction.
The predominant presentation is weakness that may affect the limbs, face, oral or eye muscle. Weakness varies greatly ranging from subtle to very severe. AFM may result in total paralysis, partial paralysis, or weakness of just one limb. The combination of paralysis and how individuals present are widely variable. The limbs or muscle structures of individuals with AFM appear weak, flaccid, or limp and are not spastic as seen in classic cases of transverse myelitis. Since it is markedly the gray matter of the spinal cord that is inflamed in individuals with AFM, sensory, bowel and bladder functions can remain intact, however there are individuals that have both upper and lower motor neuron involvement.
The enterovirus (EV-D68) has been suspect in many of these cases however, it has not been definitively proven that it is this particular virus that has caused the paralysis,(1) although several cases of AFM occurred at around the same time as an outbreak of the EV-D68 virus.(2)
There has been a spike in AFM: https://madisonarealymesupportgroup.com/2018/10/19/rise-in-acute-flaccid-myelitis-cases-and-the-link-to-vaccinations/
Within the above link, you will learn there are numerous theories on what causes AFM including viruses & vaccinations. Lyme/MSIDS patients often have viral involvement, and reactivation of Lyme has been documented after vaccinations: https://madisonarealymesupportgroup.com/2017/12/02/scottish-doctor-gives-insight-on-lyme-msids/, as well as Bartonella: https://madisonarealymesupportgroup.com/2016/04/24/gardasil-and-bartonella/
https://madisonarealymesupportgroup.com/2016/11/07/connection-of-acute-flaccid-myelitis-and-vaccinations/ In this article, James Lyons Weiler states:
The US press has been pushing a view of acute flaccid paralysis as a mysterious condition of unknown etiology (unknown cause). Checking the scientific literature, however, tells us that AFP is most often Guillain Barre Syndrome (GBS), a condition that appears on the National Vaccine Injury Compensation Program as a “Table Condition” – i.e., one that the US HHS has no defense against when parents file in the NVICP for compensation for GBS as a vaccine injury in their children. https://madisonarealymesupportgroup.com/2018/12/07/acute-flaccid-paralysis-is-most-often-guillain-barre-syndrome/
GBS is also often a player with Lyme/MSIDS: https://madisonarealymesupportgroup.com/2019/01/09/transverse-myelitis-guillain-barre-associated-with-bartonella/
https://madisonarealymesupportgroup.com/2017/07/14/clinical-association-lyme-disease-and-guillain-barre/ In Dr. Waisbren’s book, Treatment of Chronic Lyme Disease, the majority of his 51 cases of chronic Lyme had high EBV titers. He also states,
“As will be seen in other cases, the Epstein-Barr virus may be a candidate for a co-infection associated with LD.”
Waisbren often treated this co-infected patients that had EBV with 1000mg of Valtrex three times a day with good success. He also used gamma globulin (4cc twice a week).
So Lyme/MSIDS patients are at the top of the list for AFM for numerous reasons. Personally, I had a MRI at one point due to the excruciating pain in my spine and occipital headaches. This pain was unrelenting. Borrelia burgdorferi (Bb) loves the brain and spinal column. Many viruses hang out in the spine. The MRI showed nothing abnormal and I was sent home with the same pain I came with. While I believe proper antimicrobial treatment to be imperative, what finally relieved this pain for me was MSM: https://madisonarealymesupportgroup.com/2018/03/02/dmso-msm-for-lyme-msids/
Along with swelling in the spine, patients can have brain swelling as well. Within one week, I met 3 Lyme patients with Chiari, another supposed “rare” condition: https://madisonarealymesupportgroup.com/2016/04/02/chiari/ While Chiari is often caused by structural defects in the brain and spinal cord that occur during fetal development, it can also be caused due to injury, exposure to harmful substances, or infection.
When you study the Bb organism, along with the numerous coinfections, spine and brain swelling makes complete sense and needs to be studied further: https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/
There is so much research begging to be done, yet main stream medicine wants to wrap Lyme into a pretty box with a bow on top. Again, if there is any box involved with Lyme/MSIDS, it’s Pandora’s.