Archive for the ‘Lyme’ Category

First Case of B. corocidurae in Native European Presenting as Meningitis With Cranial Polyneuritis & Cavernous Sinus Thrombosis

https://www.ncbi.nlm.nih.gov/m/pubmed/30818047/

Meningitis with cranial polyneuritis and cavernous sinus thrombosis by Borrelia crocidurae. First autochthonous case in Europe.

Malincarne L, et al. Int J Infect Dis. 2019.

Abstract

Borrelia crocidurae is endemic in West Africa, where it represents the leading cause of tick-borne relapsing fever (TBRF). TBRF typically presents with high fever and systemic symptoms, followed by recurrent episodes. Neurological complications may occur during febrile relapses. B. crocidurae is considered the most neurotropic agent of TBRF and is associated to severe neurological manifestations i.e. meningitis and encephalitis.

To date, European cases of B. crocidurae infection have been reported in travelers returning from endemic areas. We report the first autochthonous case in Europe of B. crocidurae infection, presenting as meningitis with cranial polyneuritis and cavernous sinus thrombosis that were not preceded by classical febrile recurrences.

________________

**Comment**

This is important as it shows again that Borrelia burgdorferi is not the only borrelia we need to be concerned about.  While endemic in Africa, this case is in a non-traveling European demonstrating the prolific spread of ticks and subsequently the pathogens they carry:  https://madisonarealymesupportgroup.com/2019/03/09/danish-study-shows-migrating-birds-are-spreading-ticks-their-pathogens-including-places-without-sustainable-tick-populations/

https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/

It also demonstrates once again that current CDC 2-tiered testing will NEVER pick this up.  

Cranial polyneuritis = inflammation of many nerves simultaneously.

Cavernous sinus thrombosis =  when the immune system creates a blood clot to prevent bacteria or other pathogens from spreading within a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart. Typically it is caused by an infection. The clot increases pressure inside the brain which can cause damage.  Mortality is 30%.  

Symptoms of cavernous sinus thrombosis may include:

Tests for Cavernous Sinus Thrombosis

Doctors may order brain scans, including CT and MRI scans, to look for cavernous sinus thrombosis. They may also test blood or spinal fluid to check for signs of infection.

Treatment of Cavernous Sinus Thrombosis

Doctors treat cavernous sinus thrombosis with high-dose antibiotics. These are usually given though an IV drip.

Corticosteroid medications may also be used to reduce swelling. Blood thinners are sometimes given.

Surgery may be needed to drain the site of the initial infection.

Source:   https://www.webmd.com/brain/cavernous-sinus-thrombosis

 

 

 

 

 

Happy 90th to Dr. Jones, the Rock Star Who’s Treated Over 15,000 Kids With Lyme

https://www.lymedisease.org/charles-ray-jones-turns-90/

Dr. Charles Ray Jones turns 90; still helping kids with Lyme disease

 

Dr. Charles Ray Jones is the world’s leading pediatric Lyme specialist. He has treated well over 15,000 children from around the globe, over a period of more than four decades.

He has helped countless more, by training doctors and sharing his vast knowledge at conferences for both professionals and patients.

Despite years of harassment from the medical establishment, now, at age 90, Dr. Jones continues to see young patients at his office in New Haven, Connecticut. Many parents have credited him with saving the lives of their children.

His battles with medical authorities were documented in the 2008 Lyme documentary “Under Our Skin.” Here’s a clip from that:

The photo at the top of this blog is of Dr. Jones with LymeDisease.org’s founder and president, Phyllis Mervine.

LymeDisease.org joins the rest of the Lyme community in wishing a happy birthday to Dr. Jones–and we hope he’ll continue to help children with Lyme for many years to come.

_________________

For more:  https://madisonarealymesupportgroup.com/2018/11/11/gestational-lyme-other-tick-borne-diseases-dr-jones/

https://madisonarealymesupportgroup.com/2019/01/10/transmitted-in-the-womb-children-battle-lyme-disease-from-birth/

Dr. Charles Ray Jones: Straight Talk With a Fearless Pediatrician  Janet Jemmott interviews veteran Lyme disease Dr. Charles Ray Jones, introduced in our July, 2014 newsletter

A true rock star who’s saved the lives of thousands. May he live to celebrate many more birthdays and continue to train the next generation of doctors so our children can lead productive lives.

Dr. Jones Pic

https://sites.google.com/site/drjoneskids/home

Warning!!!

Google is deleting all websites of this kind in its system.
This is one of 15 Google websites I’ve been sharing info on.
I am trying to hurriedly save and transfer this information.
However, there is a deadline quickly approaching. 
If I am able to get a Children’s site up and running
It will be at the same address (I think)- www.DrJoneskids.org
Thank you for your patience and understanding.
Lucy Barnes
February 2019 

 

 

Brain Under Attack – PANS, PANDAS, & Related Developmental Disorders

http://www.betterhealthguy.com/episode88

Episode #88: Brain Under Attack with Maria Rickert Hong, CHHC, AADP

In this episode, you will learn about PANS, PANDAS, and related developmental disorders.

About My Guest

My guest for this episode is Maria Rickert Hong. Maria Rickert Hong, CHHC, AADP is a former Wall Street sell-side equity research analyst who is now a Certified Holistic Health Counselor. She is the author of the bestselling book, “Almost Autism: Recovering Children from Sensory Processing Disorder, A Reference for Parents and Practitioners” and the co-author of “Brain Under Attack: A Resource for Parents and Caregivers of Children with PANS, PANDAS, and Autoimmune Encephalitis”. As a health coach, she helps parents make diet and lifestyle changes to recover their children from symptoms of Sensory Processing Disorder, autism, PDD-NOS and ADHD. She has recovered her two boys from SPD, asthma, and acid reflux. Maria is a board member, Media Director, and blogger for Epidemic Answers, a 501(c)3 non-profit that lets parents know that recovery is possible and is the sponsoring non-profit of “The Documenting Hope Project”. Maria is also a board member of Parents as Partners.

Key Takeaways

  • What is the difference between PANDAS and PANS?
  • When does PANS generally present?
  • What are the symptoms of PANS?
  • What is the role of inflammation in PANS?
  • Do PANS and autism overlap?
  • What leads to a blood-brain barrier breach in PANS?
  • What is the role of EMFs in PANS?
  • What role do glutamate, phenolics, and salicylates play in PANS?
  • What are some of the triggers for PANS?
  • Does mold exposure play a role in PANS?
  • What tests are done to explore the potential for PANS?
  • What is the Epidemic Answers Four Step Healing plan?
  • Why is detoxification and drainage key in PANS recovery?

Connect With My Guest

http://mariarickerthong.com

Related Resources

Epidemic Answers

Brain Under Attack

My Kid Is Not Crazy

Disclaimer:  The content of this show is for informational purposes only and is not intended to diagnose, treat, or cure any illness or medical condition. Nothing in today’s discussion is meant to serve as medical advice or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority.

________________

For more:  https://madisonarealymesupportgroup.com/?s=PANS

https://madisonarealymesupportgroup.com/?s=PANDAS

https://madisonarealymesupportgroup.com/2017/10/01/panspandas-steroids-autoimmune-disease-lymemsids-the-need-for-medical-collaboration/

https://madisonarealymesupportgroup.com/2017/10/08/misdiagnosed-how-children-with-treatable-medical-issues-are-mistakenly-labeled-as-mentally-ill/

https://madisonarealymesupportgroup.com/2018/01/05/scary-side-of-childhood-strep/

https://madisonarealymesupportgroup.com/2017/12/01/guidelines-for-treating-pans-its-real/

Lyme in Slovak Republic

https://cejph.szu.cz/artkey/cjp-201888-0011_association-of-seroprevalence-and-risk-factors-in-lyme-disease.php

Association of seroprevalence and risk factors in Lyme disease

Andrea Bušová1, Erik Dorko1, Eva Feketeová2, Kvetoslava Rimárová1, Jana Diabelková1, Tímea Rovenská1, Tomáš Csank3

Cent Eur J Public Health 2018, 26(Supplement):S61-S66 | DOI: 10.21101/cejph.a5274

Objective: The aim of the presented cross-sectional seroepidemiological study was to determine the current presence of antibodies against B. burgdorferi s.l. in the groups of Slovak population, and to identify potential risk factors to Lyme borreliosis.

Methods: A group of 261 adults (patients from the Neurological Clinic with possible symptoms of LB and healthy persons with possible working exposure to tick bite: gardeners and soldiers working in afforested areas) were examined in order to assess the seroprevalence of anti-Borrelia antibodies. Sera were screened by commercial enzyme-linked immunosorbent assay (ELISA). The respondents completed questionnaires with general demographic, epidemiological and clinical data.

Results: We detected 17.2% presence of positive IgG and 5.7% presence of positive IgM antibodies in all investigated groups. Our results confirmed that the following risk factors such as age and gender are significantly associated with the presence of positive specific antibodies against investigated disease.

Conclusion: The results of seroprevalence obtained in the present study confirm the possibility of infection with B. burgdorferi among respondents exposed to contact with ticks.

_________________

**Comment**

Imagine the percentages if they used direct microscopy or even the MISDS questionnaire, not serology which misses half of cases:  https://madisonarealymesupportgroup.com/2018/10/12/direct-diagnostic-tests-for-lyme-the-closest-thing-to-an-apology-you-are-ever-going-to-get/

Key quote:  “These serologic tests cannot distinguish active infection, past infection, or reinfection.”

In plain English, these tests don’t show squat.

Please spread the word that Dr. Horowitz’s MSIDS questionnaire has been validated and predicts Lyme much better than serology:  https://madisonarealymesupportgroup.com/2017/09/05/empirical-validation-of-the-horowitz-questionnaire-for-suspected-lyme-disease/  The results support the use of the HMQ as a valid, efficient, and low-cost screening tool for medical practitioners to decide if additional testing is warranted to distinguish between Lyme disease and other illnesses.

Here it is.  You can print it off and fill it out yourself:  https://madisonarealymesupportgroup.files.wordpress.com/2016/01/symptomlist.pdf

https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/  Excerpt:

There has been an ongoing record of suppression of microscopy for Lyme.  In an interview with now retired professor of microbiology Morten Laane, the facts come rolling out on how he was fired, his lab was closed down, and his published article disappeared without a trace after presenting his findings at a scientific conference on how microscopy showed spirochetes as well as other organisms like Babesia in a number of patients (12).  Laane is far from alone.  Dr. Sin Hang Lee has even filed a $57.1 million lawsuit against the CDC for suppressing direct detection tests, and for employing ‘Lysenkoism,’ a term used for a Russian political campaign using bogus science to suppress true biological and medical sciences and to punish scientists and doctors who don’t follow Party Line (13).

BTW:  The Lyme Good Old Boys aka The Cabal own patents on Lyme serology testing:  https://crymedisease.wordpress.com/2016/02/28/the-conspirators-they-own-the-patents-and-changed-the-testing/

Employees of the U.S. Centers for Disease Control hold patents on Lyme tests:  https://www.google.com/patents/EP2805168A1?cl=en  For nearly four decades now the only FDA approved test for Lyme disease is the indirect two-tiered antibody test.

Dr. Allen Steere filed a patent in 2013 for yet more antibody detection tests for Lyme disease: (Application #20150219646) Compositions and Methods for the Detection of Bacterial Infections Associated with Lyme Disease  https://patents.justia.com/patent/20150219646

Anybody smell a rat yet?

The other issue with this study is the fact they are STILL looking this as a ONE pathogen illness when it’s typically not:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  Key Quote:  Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.” 

 

Global Lyme Alliance Announces New Partnership With Delaware Lyme Board to Help Educate Physicians About Lyme Disease

https://globallymealliance.org/press-releases/global-lyme-alliance-announces-new-partnership-delaware-lyme-board-help-educate-physicians-lyme-disease/

MARCH 12, 2019

lyme disease

CURRICULUM CREATED FOR HEALTHCARE PROVIDERS TO AID IN DIAGNOSIS AND TREATMENT OF TICK-BORNE DISEASES

STAMFORD, CONN and DOVER, DEL (March 12, 2019)—Global Lyme Alliance (GLA), the leading 501(c)(3) dedicated to conquering Lyme and other tick-borne diseases through research, education and awareness, today announced it has partnered with the state of Delaware’s Lyme Disease Education Oversight Board (LDEOB) and launched an online Lyme disease course for physicians and other healthcare professionals.

This Continuing Medical Education (CME) certified activity presents and discusses recent advances in the management of Lyme and other tick-borne illnesses. Among the topics covered are the epidemiology of Lyme, diagnostic challenges, common co-infections and routine recommendations for the testing and treatment of Lyme disease infections based on current guidelines.

“The incidence of Lyme and tick-borne disease in Delaware and nationwide is alarming and causes so much suffering,” said Sara Tyghter, GLA Director of Education and Outreach. “GLA was delighted to work with Delaware’s LDEOB to determine the learning objectives for this educational activity and help select its faculty members.”

Serving as faculty for the course, “A Clinical Guide to Diagnosing and Treating Lyme Disease and Other Tick-Borne Illnesses,” are GLA Scientific Advisory Board member Charles Chiu, M.D., Ph.D., Associate Professor of Laboratory Medicine and Medicine, University of California, San Francisco, and Elena Frid, M.D. a board-certified neurologist and clinical neurophysiologist in private practice in New York.

The course eventually came about after Delaware House Speaker Peter C. Schwartzkopf, State Senator Ernesto B. Lopez, and other Delaware state lawmakers became aware of the high incidence of Lyme and the consequent suffering it caused constituents. In 2014 lawmakers sponsored the Delaware Senate Joint Resolution 10 which was signed into law and established Delaware’s Lyme Disease Prevention Task Force. Two years later Delaware House Bill 291 created the LDEOB and reached out to GLA since it already offered CME-accredited programs. Members worked with GLA, Drs. Chiu and Frid, pictured, in collaboration with the Postgraduate Institute for Medicine and RedMedEd, an e-learning entity, to bring the Lyme disease course to fruition.

“We feel that this program is essential to help educate healthcare professionals on the complexity of Lyme disease as a multi-systemic infection that can have the potential for long-term illness if diagnosed late or inadequately treated,” said Dr. Krista Griffin, a LDEOB member. “We wanted to impress upon healthcare providers that Lyme disease is a clinical diagnosis; rash presentation or lab testing can confirm a diagnosis but should not be solely relied upon.”

Speaker Schwartzkopf added, “Delaware is right in the middle of a hotspot for Lyme disease which is misunderstood and sometimes misdiagnosed. . . Continuing Medical Education classes like this will help physicians identify Lyme early and take action quickly to limit its effects and treat patients quickly.” Senator Lopez noted, “The Delaware General Assembly values and appreciates this meaningful step forward on behalf of all affected by this illness.”

GLA is committed to providing CME-accredited educational programs for healthcare professionals to learn more about diagnosing and treating Lyme and other tick-borne diseases. For information on all its educational programs, go to GLA.org.

To access this course free of charge, visit https://globallymealliance.org/education-awareness/physicians-training-program/.

About Global Lyme Alliance
Global Lyme Alliance is the leading 501(c)(3) organization dedicated to conquering Lyme and other tick-borne diseases through research, education and awareness. GLA has gained national prominence for funding some of the most urgent and promising research in the field, while expanding education and awareness programs for the general public and physicians. We support those around the globe in need of information about tick-borne diseases. Learn more at GLA.org.

_____________________

Please spread the word to doctors that there are accredited CME’s they can obtain to become better educated on Lyme/MSIDS.

https://madisonarealymesupportgroup.com/2018/06/06/lyme-education-for-healthcare-professionals/

https://madisonarealymesupportgroup.com/2018/02/19/calling-all-doctors-please-become-educated-regarding-tick-borne-illness-heres-how/

https://madisonarealymesupportgroup.com/2017/06/20/help-doctors-get-educated-on-lyme-and-tick-borne-illness/

https://madisonarealymesupportgroup.com/2018/02/22/new-lyme-cme-course-available-lyme-carditis-more-than-blocked-beats/

 

 

 

Ozarks Woman Hopes For Tick-borne Disease Progress With Proposed Federal Legislation

https://www.ky3.com/content/news/Ozarks-woman-hopes-for-tick-borne-disease-progress-with-proposed-federal-legislation-507052841.html

Ozarks woman hopes for tick-borne disease progress with proposed federal legislation

 

https://www.ky3.com/templates/2015_Sub_Video_Share?contentObj=507052841“>https://www.ky3.com/templates/2015_Sub_Video_Share?contentObj=507052841  News Video Here

You probably try to protect yourself and your children from ticks and the diseases they carry with insect repellents. But new federal legislation would add resources to the battle against Lyme disease and other tick-borne diseases.

The Centers for Disease Control estimates 300,000 people are diagnosed with Lyme disease each year in the U.S. The proposed legislation would crate a new national strategy to combat tick-borne diseases.

The bill would create an office of oversight and coordination for tick-borne diseases in the Department of Health and Human Services.
It would expand and enhance research, develop new and better diagnostic tests and seek safe and effective vaccines.

Lori Geurin, who lives near Bolivar, hopes more resources are put toward exploring tick-borne diseases. She started having flu like symptoms and severe fatigue about seven years ago.

“My whole body was in pain, and I couldn’t sleep at all,” says Geurin. “I would have night after night of no sleep at all, and I was teaching and a mom of four children and a wife. And it was just all I could do to get up in the morning and get out of bed.”

A year and a half later, Geurin says she tested positive for Lyme disease in one test from a private company, one from her doctor, plus another tick borne disease called tularemia.

“He said that my symptoms, if I had been to the northeast, that he would diagnose me with Lyme because my symptoms were consistent with Lyme,” says Geurin.

“But because I hadn’t been to the northeast, I didn’t have Lyme disease.”

Her long search for answers is one reason she believes more research is needed on Lyme disease and other tick borne illnesses.

“I’ve read a lot that there isn’t enough funding for Lyme, and there’s so many people out there that I hear from every week have the same symptoms and they’ve been told the same things,” says Geurin.

Congresswoman Vicky Hartzler is one of many co-sponsors to the bill, House Resolution 220. It’s been introduced in the house and referred to the House Committee on Energy and Commerce.

__________________

**Comment**

Another patient told they can’t have Lyme because it doesn’t show up on a man-made map. This is 2019, with information coming out on a daily basis on the spread of ticks and tick borne illness, yet doctors STILL have their heads in the sand.

This, right here, is a very real reason why thousands go undiagnosed.

Medical stupidity.

These maps are outdated and do not explain the whole story. Doctors, please use your God-given brains. Do not smugly rely on outdated information.  Be informed.  Do your homework.

Quit looking at maps and start listening to patients!

For more:  https://madisonarealymesupportgroup.com/2018/07/16/ticks-that-carry-lyme-disease-are-spreading-fast/

This tick border thing is a man-made constructed paradigm that has never been accurate, but it’s fit the CDC/NIH/IDSA narrative.  http://steveclarknd.com/wp-content/uploads/2013/11/The-Confounding-Debate-Over-Lyme-Disease-in-the-South-DiscoverMagazine.com_.pdf (go to page 6 and read about Speilman’s maps which are faulty but have ruled like the Iron Curtain, and have been used to keep folks from being diagnosed and treated)

TIME TO PULL THE BLINDERS OFF AND LOOK AT THIS THING AS THE PANDEMIC IT TRULY IS.

There is Lyme in the South:  

https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/

https://madisonarealymesupportgroup.com/2017/03/02/hold-the-press-arkansas-has-lyme/

https://madisonarealymesupportgroup.com/2016/10/25/hope-for-southerners/

 

 

 

Small Fiber Neuropathy & PTLDS

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212222

Association of small fiber neuropathy and post treatment Lyme disease syndrome

Peter Novak , Donna Felsenstein, Charlotte Mao, Nadlyne R. Octavien, Nevena Zubcevik

Published: February 12, 2019  https://doi.org/10.1371/journal.pone.0212222

Abstract

Objectives

To examine whether post-treatment Lyme disease syndrome (PTLDS) defined by fatigue, cognitive complaints and widespread pain following the treatment of Lyme disease is associated with small fiber neuropathy (SFN) manifesting as autonomic and sensory dysfunction.

Methods

This single center, retrospective study evaluated subjects with PTLDS. Skin biopsies for assessment of epidermal nerve fiber density (ENFD), sweat gland nerve fiber density (SGNFD) and functional autonomic testing (deep breathing, Valsalva maneuver and tilt test) were performed to assess SFN, severity of dysautonomia and cerebral blood flow abnormalities. Heart rate, end tidal CO2, blood pressure, and cerebral blood flow velocity (CBFv) from middle cerebral artery using transcranial Doppler were monitored.

Results

10 participants, 5/5 women/men, age 51.3 ± 14.7 years, BMI 27.6 ± 7.3 were analyzed. All participants were positive for Lyme infection by CDC criteria. At least one skin biopsy was abnormal in all ten participants. Abnormal ENFD was found in 9 participants, abnormal SGNFD in 5 participants, and both abnormal ENFD and SGNFD were detected in 4 participants. Parasympathetic failure was found in 7 participants and mild or moderate sympathetic adrenergic failure in all participants. Abnormal total CBFv score was found in all ten participants. Low orthostatic CBFv was found in 7 participants, three additional participants had abnormally reduced supine CBFv.

Conclusions

SFN appears to be associated with PTLDS and may be responsible for certain sensory symptoms. In addition, dysautonomia related to SFN and abnormal CBFv also seem to be linked to PTLDS. Reduced orthostatic CBFv can be associated with cerebral hypoperfusion and may lead to cognitive dysfunction. Autonomic failure detected in PTLDS is mild to moderate. SFN evaluation may be useful in PTLDS.

________________

**Comment**

Keep in mind, researchers by nature have to obtain as close to ground zero as possible.  In this case they chose to use the unscientific and abysmal CDC 2-tiered blood serology which research has shown misses over half of all cases.  It was also never intended for diagnosis but for surveillance purposes only.  Lyme should be a clinical diagnosis.  We desperately need a better form of accurate testing for this very reason.  Nearly ALL research is based upon 2-tiered serology which leaves out a huge subset of patients.  

Some of the sickest people NEVER test positive using CDC criteria.

Also, please note:  

All patients had received a course of antibiotics for Lyme disease including 3 weeks of oral doxycycline as recommended by Infectious Diseases Society of America (IDSA) guidelines [13,30]. Because of symptoms persistence, all participants were treated with additional antibiotics (data in S1 Table). The list may not be accurate and may underestimate the antibiotic therapy as many participants were treated in multiple institutions and as such medical records may be incomplete.

Many would argue that the entire premise of this research article is flawed in that the CDC moniker of PTLDS is not taking into account persistent/chronic infection.  For a fantastic read on that:  https://madisonarealymesupportgroup.com/2019/02/25/medical-stalemate-what-causes-continuing-symptoms-after-lyme-treatment/

Until this issue is resolved, people will be put into two camps based on a false premise, 1) Acute cases 2) PTLDS.  There are numerous subsets of people.  See link above.

Parasympathetic failure & low orthostatic CBFv  was noted in 7 out of 10 patients and abnormal total CBFv score was found in all 10!
All of you out there suffering with dry eye & mouth, inability to digest food, and having colitis type symptoms (either diarrhea or constipation – usually alternating) this study reveals why.
Lyme loves the spine!  
1503_Connections_of_the_Parasympathetic_Nervous_System

By OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148020

You can visualize where on the spine the various organs receive information from.  Notice all the things connected to the cranial nerves at the top.  Please know Bartonella and other coinfections can affect these areas as well.  Dr. Ericson’s found Bart all over the place:  https://madisonarealymesupportgroup.com/2019/02/27/advanced-imaging-found-bartonella-around-pic-line/  Take a gander at her slides where she’s found Bart in collagen, where a PIC line was removed, skin biopsies (including the brain), cartilage, and blood cells.

Lastly, besides the spinal involvement, notice ALL of the patients had an abnormal Total CBFv score.  This is cerebral blood flow velocity from the middle cerebral artery.  Not enough blood flow = not enough oxygen, which is required for normal functioning.  It alone can account for brain fog and fatigue.  Too much blood flow = swelling and inflammation which can cause severe pain and even lead to Chiari:  https://madisonarealymesupportgroup.com/2016/04/02/chiari/  In one week I met 3 Lyme patients with a Chiari diagnosis.  I had an MRI to rule it out myself.

One drug that was most effective for me for this issue was Minocycline:  https://madisonarealymesupportgroup.com/2017/06/04/minocycline-for-ms-and-much-more/