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[Dysphagia] Lyme disease

There is no test that can determine if a patient is infected with the LD bacterium and then demonstrate that the patient has become bacterium-free. Therefore, LD is clinical diagnosis, based on signs and symptoms, with the patient's travel history to endemic areas and test results being additional pieces of information in the complete picture. No test can "rule-out" Lyme disease.

Signs and symptoms of early local Lyme Disease often starts with flu-like feelings of headache, stiff neck, fever, muscle aches, and fatigue. About 60% of light-skinned patients notice a unique enlarging rash days to weeks after the bite. On dark-skinned people, the rash resembles a bruise.

The rash may appear within a day of the bite or as late as a month later. This rash may start as a small, reddish bump about one-half inch in diameter. It may be slightly raised or flat. It soon expands outward, often leaving a clearing (normal flesh color) in the center. It can enlarge to the size of a thumb-print or cover a persons back.

To be considered local disease the rash must be at the tick bite site with no other major organ system involvement. Some people don?t notice these early indicators of infection. Early manifestations usually disappear, and disseminated (other organ system involvement) infection may occur. General symptoms alone do not indicate Lyme disease. Disseminated Lyme disease may produce:
Nerve conduction defects (weakness/paralysis of limbs, loss of reflexes, tingling sensations of the extremities - peripheral neuropathy), severe headaches, stiff neck, meningitis, cranial nerve involvement, difficulty chewing, swallowing, or speaking; hoarseness or vocal cord problems; facial paralysis - Bell's palsy; dizziness/fainting; drooping shoulders; inability to turn head; light or sound sensitivity; change in hearing; deviation of eyeball [wandering or lazy eye], drooping eyelid), stroke, abnormal brain waves or seizures, sleep disorders, cognitive changes (memory problems, difficulty in word finding, confusion, decreased concentration, problems with numbers) and, behavioral changes (depression, personality changes).

Other psychiatric manifestations include: panic attacks; disorientation; hallucinations; extreme agitation; impulsive violence, manic, or obsessive behavior; paranoia; schiziphrenic-like states, dementia, and eating disorders. 
Other disseminated skin problems include:lymphocytoma, which is a benign nodule or tumor, and acrodermatitis chronica atrophicans (ACA) which is discoloration/degeneration usually of the hands or feet. 



Cheryl Goettsche <cagoettsche@yahoo.com> wrote:
My colleague and I have just completed an evaluation with a gentleman who was recently diagnosed with ALS. He has also been receiving treatment for Lyme disease, which he had for 1 1/2 years before being diagnosed, he has been receiving tx for the past 1 1/2 years. He has also been receiving some conflicting information from the many doctors that he has been seeing, he has Lyme disease, he does not have Lyme disease. The characteristics that he displayed during the evaluation were consistent with those of individuals with ALS.
He posed a question to us, "Have you ever seen neurological damage, or speech and swallowing difficulties similar to those with ALS in individuals with Lyme disease?" We could not give him an answer.
So I am hoping someone out there may be able to help us give this gentleman some answers to his questions. 

Cheryl Goettsche, MS., CF-SLP

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