It is difficult for an individual to encounter clinical symptoms, such as muscle twitching, fatigue, slurred speech, etc. What could be the reason behind these symptoms? Lyme disease is a bacterial infection, which is transmitted through the bite of black-legged ticks. When detected early, the clinical symptoms can be managed with antibiotic therapy.
Sometimes, the bacteria crosses the blood-brain barrier and results in neurological manifestations. There is a high chance to confuse these neurological symptoms with neurodegenerative conditions, such as ALS.
Can Lyme disease mimic ALS? In this blog, we will discuss overlapping clinical symptoms of the two conditions and real-life case studies.
What are the clinical symptoms of ALS and Lyme disease?
Lyme disease:
Lyme disease is caused by the bacterium, “Borrelia burgdorferi”, and is spread through the bite of infected ticks. There are three stages associated with Lyme disease.
- Early localized
- Early disseminated
- Late disease
If the disease is not treated in early stages, it can result in neurological signs, encephalopathy, cardiac symptoms and arthritis. In the initial stage, concentric rings can appear at the site of tick bite.
Early localized disease:
Early localized stage is characterized by bull’s eye rashes and fever. Skin rashes are seen in 70% of the individuals. If treatment is not considered at this stage, the rashes continue for 2-3 weeks and expand in size. Along with the fever, myalgia and headache can also occur.
Early disseminated disease:
This phase develops within 3-12 weeks after the initial stage. The clinical symptoms can include,
- Dizziness
- Headache
- Palpitations
- Dyspnoea
- Bell’s palsy (Affect 5% of the patients)
- Heart block
- Cranial neuropathy
- Conjunctivitis
Late disease:
This stage occurs after several months of the early phase. The individual may experience joint pain, bursitis, memory loss, clinical depression, ataxia, etc.
Treatment options
The preferred treatment options include oral or intravenous administration of antibiotics. A temporary/permanent pacemaker can be used in patients with symptomatic heart block. Usually, the treatment is effective in early cases. The management strategies can become ineffective due to late diagnosis.
Amyotrophic lateral sclerosis:
Amyotrophic lateral sclerosis (ALS) is a neurological condition that causes degeneration of motor neurons. As a result, the brain will lose the ability to control voluntary movements.
Clinical symptoms:
- Muscle twitching
- Slurred speech
- Dysphagia
- Constipation
Treatment:
The US Food and Drug Administration (FDA) has approved certain drugs for managing the symptoms of ALS. Riluzole is an oral medication that decreases glutamate levels and reduces degeneration of motor neurons. This medicine has the ability to increase the survival rate of patients for a few more months.
Patients who experience trouble swallowing can take the liquid form of the drug. An antioxidant, called Edaravone can be administered orally or intravenously. It slows down the functional decline in some patients with ALS. Along with medicines, physical and supportive therapy can help to manage the symptoms.
