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Lyme Disease in Autism: Diagnosis and Treatment Options

Introduction

Inflammation/ oxydative stress

Diagnosis

Disease paradigm Antibiotic Treatment

Naturopathic approaches

A parent perspective

Lyme disease is spread by the bite of ticks of the genus Ixodes (deer tick) that are infected with Borrelia burgdorferi.

USA: Essentially Borrelia burgdorferi.Europe: B. afzelii, B. garinii, B. burgdorferi, and occasionally other species of borrelia

Scanning electron micrograph image of Borrelia burgdorferi. Image-Wadsworth Center, New York State Department of Health

Lyme Disease Agents

Two Year Life-Cycle Deer Tick

Life cycle of Borrelia is linked to the tick life cycle

Reported Cases of Lyme Disease—United States, 2010. Source CDC

Lyme Disease Symptoms

Early Symptoms(Acute)

Late Symptoms(Chronic)

Erythema migrans seen in 50% of peopleLess frequently still in EU

Common symptoms:Profound fatigueChills, sweats ad skin flushesMigrating arthralgiaMuscle pain/ twitchingSevere headachesTremorsNumbness/ Tingling sensations, pain shiftingCranial nerves disturbancesCont...

“The Great Imitator”

Neurological symptoms associated with late stage Lyme disease:Progressive dementiaSeizure disordersALS-like symptoms (similar to Lou Gehrig’s disease)Gillian-Barre-like symptomsMultiple Sclerosis-like symptomsParkinson’s disease-like symptomsOther extrapyramidal disordersVisual disturbances or loss

Loss of attention/ executive functions, auditory and mental tracking and memory retrieval. These will impact on:

Memory functionsLanguage functionsVisual and spatial processingAbstract reasoningProcessing speed

Lyme Disease Symptoms Cont.

The prolonged immune response, trying to fight Borrelia burgdorferi infection, causes most of the symptoms of Lyme disease, including joint inflammation, skin changes, and neurological problems.

Systemic inflammation

Characteristic morphology of Borrelia burgdorferi (Dark field microscopy images of Borrelia burgdorferi strain B31 showing the usual spiral form of spirochetes (A) and their agglomeration into colony-like masses (B)

Spirochete and colony-like Borrelia forms

Rolled and cystic forms of Borrelia burgdoferi spirochetes observed after one week of culture in medium to which Thioflavin S had been added.

Cystic Borrelia forms

Atypical and cystic Borrelia forms following 1 week exposure of primary neuronal and astrocytic cultures to Borrelia burgdorferi. C: OspA positive Borrelia spirochetes closely surrounding neurons (strain B31). D: Atypical filamentous and ring-shaped cystic, apparently intra-cellular spirochetes in a neuron (strain B31).

Intracellular and cystic Borrelia forms

Chronic neuroinflammation in the frontal cortex of a patient with Lyme neuroborreliosis. First column (A, D and G): Accumulation of HLA-DR (A) and CD68 (D) immunoreactive microglia forming clumps, and GFAP (G) positive large reactive astrocytes in the frontal cortex of a patient with Lyme neuroborreliosis.

Systemic Inflammation in Lyme’s Disease

Systemic inflammation in Autism

Diagnosis of Lyme1- Detection of Borrelia agents

PCR, Serology and Elispot

2- Co-infections: Ehrlichia, Babesia, Bartonella, Yersinia, Toxoplasma gondii, Anaplasma phagocytophilum, and other potential infections that can affect health: Streptococcus A, Chlamydia, Mycoplasma, Borrelia burgdorferi2- Clinical symptoms of chronic infection

Sweating, excessive thirst, level of activity, fatigue, body temperature regulation issues, muscle tones, skin flushing, rash, motor and cognitive functions, pain, hearing sensitivity.

3- Complementary lab workNatural Killer cell counts: NK1, NK2, NK3Complete blood countInflammation MarkersAuto-immune issuesLiver/ Kidney functionNutritional markersHormonal profile

Infectious Diseases Society of America (IDSA), American Academy of Neurology, Centers for Disease Control and Prevention NIH, NHS:

Chronic Lyme does not exist.Advise against long-term antibiotic treatment.No other treatment considered.

International Lyme And Associated Diseases Society (ILADS):

Symptoms of Chronic Lyme are real and associated with remaining BorreliaLong-term treatment of infection is required.

The Lyme War

Treatment OptionsGeneral points

Remove StressorsGF/CF –SCD- Sugar etc.

AllergensToxins

Optimal metabolism & physiologyNutritionDigestion

Immune systemLiver & kidney functions

Hormonal

Treat the InfectionThree Borrelia stages to consider

& Potential co-infections

Example of antibiotic regimen

Heirxheimer reaction proves that inflammation causes a wide range of behavioural and healthDisturbances

Cholestyramine- Questran ideally version without Aspartame

Activated charcoal

Aspirin

Hydrocortisone (100mg) During AB treatment

Prednisolone during AB treatment

Systemic Enzymes e.g Wobenzymes

Breaks in treatments

Sauna/ detoxification

Other problems associated with prolonged antibiotic use

•Yeast and clostridia flare ups

•Liver and kidney function

•Heart

•Eye sight

•Drug-drug interaction

Core protocol Andrographis Paniculata standardised to 10% andrographolids

anti-inflammatory, antibacterial, anti-viral, anti-malarial, vermicidal, immunostimulant, sedative, hepatoprotective. Crosses blood brain barrier. Neuroborreliosis, low immune function.

Japanese Knotweed (Resvertrol) Broadly systemic plant. Acts against a number of Gram + and Gram - bacteria. Enhahnces blood flow. Co-Infection, Neuroborreliosis. Anti-viral (Herpes etc). Anti-inflammatory (diminish arachidonic acid pro-inflammatory metabolites and raises white blood cell count).

Cat's Claw (uncaria tomentosa) immune potentiator, anti-inflammatory, cognition, raises NK cell count, raises neutrophil cell count., late stages of chronic infection, helps with memory deficit and relaxes the CNS.

Astragalus Immune enhancer, modulator, stimulant, antiviral, antibacterial, GI tract. Good for Lyme residing in an endemic area, chronic fatigue, night sweats, pre and early Lyme- may not be suitable in late Lyme if auto-immune issues coexist. Ehrlichia infection. Inhibit NF-KB pathway. Improved issues of memory impairement in Lyme

Smilax Systemic plant, Heirxheimer- binds to toxins in the blood, immunomodulatory, antibacterial, antiv viral, neuroprotective, antioxydant, antifungal, anti fatigue. Enhences cognitive function. Neuroborreliosis.

Bee Venom Potent antioxidant, antifungal, antibacterial, antiinflammatoryExtending the protocol Siberian Ginseng (Eleuthero) Strongly initiate response to spirochete infection. Immune tonic and potentiator,

adrenal tonic, antidepressant, mental clarity, restore energy levels.

Kalmegh, Lycopodium clavatum also used for epilepsy, Periwinkle (vinpocetine) (V minor, V major), cerebral blood flow and cognitive function. Red Root (Ceanothus americanus or equivalent) Artemesinin (Artemisia annua), Autumn crocus (Colchicum autumnale) surijan-i-talkh etc.

Buhner’s protocol

Alternative Treatment Options?Electromedicine –Rifle machineMortar Oscillatory Rate (MOR)