The Lyme disease is very dangerous, especially because it involves neurological aspect and effects nervous system of a person contaminated with Lyme disease bacteria. The current paper will investigate Lyme disease indications, prognosis, particularly concentrating on the neurological aspect of the illness. In addition, the paper will provide the information concerning the possible benefits, which can be achieved with the help of physical treatment that may eliminate post-antibiotic treatment syndromes and other negative disease effects.
Lyme disease (also known as Lyme borreliosis) is considered a contagious affection, which is provoked by at any rate three kinds of bacteria, which belong to the special genus referred to as Borrelia (Yanielli, Alcamo, & Heymann, 2004). In fact, Lyme disease was named after the Lyme city in Connecticut. That is the place where the disease was detected in 1975 (Yanielli, Alcamo, & Heymann, 2004, p. 14). Doctors, specialists and researchers originally referred to the disease as “Lyme arthritis” as they observed the presence of untypical rheumatic or arthritic indications and signs in infants, who dwelled in the above-mentioned town. Currently, it is known that the disease is transmitted through a morsel of a contaminated tick. First or preliminary symptoms can encompass pyrexia, migraine, and weariness. An erythema appears in 70 to 80 percent of infected individuals starting with the location of a morsel following the retention of 3 to 30 days (Strasheim, 2009). The medium and typical period takes approximately 7 days (Yanielli, Alcamo, & Heymann, 2004, p. 26). Moreover, despite the fact that erythema migrans (known as ‘bull-eye’) are considered a serious indicator of Lyme disease, this indicator may not occur. The erythema is uncommonly afflictive or itching, despite the fact that it can feel warm at the touch. The facts demonstrate that approximately 20 to 30 percent of contaminated individuals do not suffer from an erythema. If the disease is left non-medicated, posterior danger signs can affect the articulations, heart system, and central nervous system (Strasheim, 2009). In the majority of cases, the disease and its indications are treated with the help of antibiotics, particularly when the Lyme disease is medicated at the first phase. On the other hand, when the treatment is suspended or inappropriate, it may result in much more hazardous indications, which either cannot be treated or are very hard to medicate (Yanielli, Alcamo, & Heymann, 2004, p. 36).
Lyme disease is the most universal tick-transmitted affection in the Northern Hemisphere. The facts demonstrate that in 2013, 95 percent of the approved Lyme disease cases have been announced by 14 states, including Connecticut, Maine, New Jersey, Virginia, New York, Pennsylvania, Maryland, etc. Approximately 300,000 individuals in the U.S. are diagnosed with Lyme disease each year. This figure is 10 times higher than it has been formerly.
There are three main stages of Lyme disease.
Lyme Disease – Clinical Stages
Stage I (when the disease is detected early)
Erythema migrans rash at tick bite size
Stage II (when the disease is early disseminated)
Stage III (when the disease is localized or disseminated at the late stage)
months to year
Figure 1. Stages of Lyme disease.
The first one stands for early Lyme disease stage. The affection begins after the affected tick ejects its salivary gland and enteric contents into the human derma (Liveris, Schwartz, Bittker, Cooper, Iyer, Cox & Wormser, 211, p. 2166). The rash observed after the ejection is named ‘migrans’, due to the fact that it grows in size, cautiously enlarging during a couple of days to more than 2 inches in diameter (Yanielli, Alcamo, & Heymann, 2004, p. 35). During this stage, patients are frequently temperate to serious flu-similar indications, including weariness, rigors, fevers, headache, muscle and joint pains, inflated lymph nodes) (Liveris, Schwartz, Bittker, Cooper, Iyer, Cox & Wormser, 211, p. 2166). In approximately 18 percent of cases, the traditional well-known clinical characteristics and indications of Lyme disease are not diagnosed (Halperin, 2014, p. 1268). Because weariness and flu-similar indications may be frequently caused by different illnesses, Lyme disease is believed to be a different diagnosis and the patient infuriates for several months because of an unspecified and untreated transmissible disease (Strasheim, 2009).
The second stage concerns late disseminated Lyme disease. If the disease is not diagnosed at the early stage, the affection may extend to other body parts. This can take place after some weeks, affecting the central nervous system (especially the brain), the peripheral nervous system (meaning the nerves), and the cardiovascular system (provoking inflammation of pericardium and heart block and eventual decease when the disease is not medicated instantly). It can also affect the liver (provoking medium hepatitis), eyes (provoking inflammation of the eye conjunctive), and joints and muscles (provoking migratory tuber, sensitivity, and ache) (Yanielli, Alcamo, & Heymann, 2004, p. 108). The standard set of indications connected with disseminated Lyme disease includes severe weakness with the need for afternoon naps, low-grade rigors, muscle and joint aches, sleep troubles, impatience, headache, light or severe sensibility, pointed cutting, shooting aches, insensitivity and tingling (Halperin, 2014, p. 1270).
In case the disease negatively affects the nervous system, it causes the indications of meningitis, encephalitis, or cranial neuritis. Meningitis is defined by headache, which differs in vehemence from medium to strong with or without aggregated sickness, eructation, low level of sensibility, neck immobility, or ache during eye movements (Halperin, 2014, p. 1268). On the other hand, encephalitis is usually associated with drowsiness, mood changes and irritability, unusual involuntary tearfulness or individuality alteration, cognitive issues including memory detriment, decelerated noetic velocity, balance issues, and sensory hyper arousal (Yanielli, Alcamo, & Heymann, 2004, p. 116). Finally, cranial neuritis typically causes CN VII Palsy as a result of Lyme disease. This illness stands for the facial nerve frailty. This cranial neuritis form is considered typical; nevertheless, the researches demonstrate that it may be observed in only 10 percent of cases of the neurologic Lyme disease (Wright, Riedel, Talwani, & Gilliam, 2012, p. 1087). Usually, a cranial neuritis appears in several days or weeks after the original affection caused by a tick. In a case when patients observe anomalism in facial perception, it may mean the inflammation of the trigeminal cranial nerve. In a case when central eyesight becomes turbid or if the eye motion is painful, these might be indications of an optic neuritis (Aucott, Rebman, Crowder, & Kortte, 2013, p. 76). Thus, Lyme disease may cause blindness if the problem is not discovered and medicated early. If cranial neuritis III, IV, or VI are present, the patient may experience double vision. Moreover, cranial neuritis VIII provokes patients to observe tinkling in their ears (also know as tinnitus), detriment of audition, dizziness, or ataxy. Lyme disease can also provoke radiculoneuritis. The case when the contamination of Lyme disease influences the nerve roots is known as radiculoneuropathy.
Usual indications include radicular ache and symmetrical or asymmetrical susceptible anomalism, including insensibility or tingling (Chandra, Wormser, Marques, Latov, & Aleadini, 2011, p. 767). The radicular ache might be felt as pointed stabbing, burning or shooting aches, which emit down a dermatomal dispensation, especially into the arms and legs or along the torso. The illness can also provoke indications of nimble frailty (Halperin, 2014, p. 1271).
The third stage of Lyme disease stands for the late neurologic Lyme disease. This is a period when Lyme disease causes serious and solid neurological problems. Firstly, it caused encephalopathy. Patients might experience cognitive issues because of Lyme disease after either several month of initial contamination or many months/years after that. The cognitive issues usually include difficulties with short-term recollection, issues with verbal evenness (for example in name or word restoration), and issues of deliberated thinking velocity (Aucott et al., 2013, p. 79). On a practical level, adults might face difficulties while keeping up to the typical conversations speed, while children might find it complicated to do homework and exercises or even fail to remember whether they did the homework assignments (Yanielli, Alcamo, & Heymann, 2004, p. 211). Because the patient experiences slower processing velocity, usual responsibilities require time and efforts and a person might feel mentally slow. Secondly, the Lyme disease may cause encephalomyelitis. Encephalomyelitis is featured by encephalitis with a mixture of serious psychiatric disorders, chorea, cerebella ataxy, and convulsions. Patients might have a whole set of indications, which look like the ostend of multiple sclerosis. However, it is important to know that in the case of Lyme disease oligoclonal bands in the CSF are less typical than in the case of multiple sclerosis. Thirdly, the Lyme disease results in neuropsychiatric Lyme disease (Chandra et al., 2011, p. 767).
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Neuropsychiatric indications can appear during the disseminated stage of affection. These indications usually occur as cognitive indications and impatience, spontaneous tearfulness, uneasiness, and doldrums. However, patients with untreated Lyme disease might suffer from an obsessive-compulsive disorder, persecution complex, hearing/seeing delusions, or full-blown frenzies (Halperin, 2014, p. 1270). Sleep disorders are also typical for Lyme disease, when the patients frequently report a need for more and more hours of sleeping, incorporating naps during the daytime (Aucott et al., 2013, p. 82). Perception hyper arousal is observed in approximately 50 percent of patients with a higher phase of neurologic Lyme disease, most frequently influencing auditory and vision functions. Such patients may make use of earplugs, sound covers, and sunglasses in the building. Ordinary susceptible stimulus may over-propel, provoking dismay and causing limbic panic as if a person had been attacked (Strasheim, 2009, p. 213). Psychiatric issues can also be observed in case of the Lyme disease. It is important to understand that the majority of psychiatric disorders have nothing in common with Lyme disease itself. It is also crucial to focus on the fact that when patients with Lyme disease face a psychiatric problem, the overall therapy of the psychiatric issues should not be disregarded (Halperin, 2014, p. 1268).
During the early stages of Lyme disease, it can be efficiently medicated with the help of antibiotics. Typically, the earlier a therapy and medication start after the initial contamination, the sooner and more effective the overall convalescence will be (Liveris, Schwartz, Bittker, Cooper, Iyer, Cox & Wormser, 211, p. 2166). Such antibiotics as doxycycline and amoxicillin taken orally for about four weeks may fasten the incarnation of the erythema and may typically impede such consequent indications as arthritis and neurological issues (Liveris et al., 2011, p. 2168). The scientists did not find any insuperable argumentation that continued antibiotic treatment is more efficient than a two weeks therapy. Extended antibiotic usage might have severe undesirable effects (Chandra et al., 2011, p. 768).
Intravenous (IV) antibiotics might be utilized for issues that are more complicated and for those people whose nervous system has been already negatively influenced (Kowalski, Tata, Berth, Mathiason, & Agger, 2010, p. 512). Lyme disease with arthritis may also be medicated with a help of antibiotics (Aucott et al., 2013, p. 82). The majority of patients undergo complete convalescence. On the other hand, patients who are younger than 9 years, pregnant or lactating females contaminated with Lyme disease are medicated with amoxicillin or penicillin because doxycycline may smudge the constant teeth evolvement in young infants or upcoming newborns (Halperin, 2014, p. 1269). Those patients who are allergic to penicillin are provided with erythromycin or other antibiotics of that kind. Specialists are more partial to medicate Lyme disease patients having heart indications with such antibiotics as Rocephin, Claforan, or penicillin, which are provided intravenously for approximately two weeks (Kowalski et al., 2010, p. 513). If the indicators remain or are very serious, people can also be medicated with corticosteroids or provided with a provisional inner cardiac pacemaker. Patients with Lyme disease seldom suffer from long-lasting heart injury (Strasheim, 2009, p. 197).
After the overall medication of Lyme disease, a number of people still have continuous weariness. This common ailment can take months to be completely eliminated, however it usually disappears involuntarily without the usage of supplementary antibiotic treatment (Kowalski et al., 2010, p. 513). There is no argument that the Borrelia affection provokes chronic weariness syndrome or fibromyalgia. Despite the fact that a number of patients with Lyme disease might have these issues, prolonged antibiotic treatment will not accelerate the overall convalescence (Chandra et al., 2011, p. 767). After the antibiotic treatment, a limited number of patients still have some indications, such as muscle pain and weariness. The reason of these prolonged indications is unrevealed, and treatment with further amount of antibiotics will not help solve the problem (Aucott et al., 2013, p. 83). Some specialists consider that particular patients who suffer from Lyme disease are inclined to an autoimmune repercussion, which promotes all previous manifestations (Kowalski et al., 2010, p. 513). Thus, a quite limited number of people with Lyme disease suffer from indications, which last for years, even after the antibiotic treatment. These indications can incorporate myalgias and arthralgias, arthritis, cognitive deficiency, sleeping problems, and weariness (Strasheim, 2009, p. 234). The origin of the indications is still unknown and mysterious.
Nevertheless, it is important to understand that antibiotic treatment is not the only treatment, which can be utilized to help patients with Lyme disease. A number of specialists accentuate on the overall promotion of exercising among Lyme patients. There is a couple of assumptions, which demonstrate why exercising may actually help Lyme victims (Chandra et al., 2011, p. 769). The first theory demonstrates that the physical activity is important as it helps increase the oxygen levels in all cells and tissues. The facts show that the Lyme-peculiar bacterium dies when it experiences even comparatively limited oxygen densities. In addition, it is known that the bacteria are also vulnerable to warmth (Halperin, 2014, p. 1270). When a person performs persistent and wearisome exercising, the core body temperature elevates, eventually exterminating bacteria themselves. Furthermore, exercising customarily brings advantages to the immune system, which is exhausted by Lyme disease. Therefore, physical treatment may include different exercising and therapy types. Firstly, physical therapies incorporate manual therapy, which includes massages, stretching together with overall joint mobilization, which allows enhancing the body alignment, motility and motion ambit. In addition, such type of treatment helps facilitate the pain in the wounded joints (Moser, 2011, p. 1419). Secondly, physical therapy incorporates mechanical modes, annexing ultrasound, electrical stimulus, laser, ice and heat to reduce ache and suppuration (Wright et al., 2012, p. 1087). Thirdly, physical therapy annexes special stretching and enforcement practices program, which helps to enhance the overall motion range as well as reinforce those muscles, which assist in enduring emaciated outward joints (Khatchikian et al., 2014, p. 1409). Fourthly, physical practice involves walking and balance exercises together with other mechanic workouts (Wright et al., 2012, p. 1089). This type of physical therapy helps some Lyme disease patients to enhance motion techniques and lower the tensions and pressure in joints, which might be provoked by everyday operations (Moser, 2011, p. 1412).
There is an opinion that early stage Lyme disease can only be medicated with the help of antibiotics and such appendage medications as, for example, analgesics (Kowalski et al., 2010, p. 513). Nevertheless, a number of specialists will delegate those patients who have chronic Lyme disease indications, which do not react to medications or physical therapy. In accordance with a physician’s index particularly elaborated for the Lyme Disease Association, Inc., physical therapy plays a very important role.
Physical therapy performs primarily a function of relieving pain during the Lyme disease treatment process (Khatchikian et al., 2014, p. 1409). It also arranges and adapts unable patients to start a home-grounded exercise project and program, and to provide patients with the information concerning appropriate exercise techniques and periodicity, continuance, and counteraction aimed at improving health without extending and intensifying Lyme-associated indications (Moser, 2011, p. 1412). Direct physical therapy intrusions incorporate acupressure, motion range, myofascial disjunction, and various modalities involving ultrasound, moist heat, and paraffin. Typically, ice packs and electrical stimulus are considered to be contraindicated; however, there are no investigations, which will help to argue this information (Moser, 2011, p. 1414). Exercise appointment is aimed at enhancing the vigor and systematically strengthening the overall patient’s constraining level, which may be seriously weakened due to the presence of chronic Lyme infection (Khatchikian et al., 2014, p. 1409). Entire-body exercises typically characterize far-reaching stretching, gentle to medium calisthenics, and light counteraction workouts with a limited number and level of weights and high levels of reiterations (Moser, 2011, p. 1412). Furthermore, many patients who have peculiar neurological complicities, especially facial nerve paralysis (know as Bell’s Palsy) may also be recommended to go through physical therapy (Chandra et al., 2011, p. 770). Electrical stimulus of paralytic or feeble facial muscles after the Lyme-connected neurological assault is believed to be universal practice, even despite the fact that the overall investigation does not completely sustain its application (Khatchikian et al., 2014, p. 1409).
There are a number of randomized-managed and arranged tests examining its efficiency. Those tests demonstrate that the practice may be neither hazardous nor advantageous, as the majority of therapists take a traditional angle and wait for numerous months between symptom occurrence and initiation of a stimulation process, which will allow natural neurological convalescence to appear (Moser, 2011, p. 1417). On the other hand, neuromuscular re-teaching has been defined as advantageous in case of facial palsy, similarly to EMG biofeedback (Khatchikian et al., 2014, p. 1409).
The current paper demonstrated the indication and prognosis of the Lyme disease. It is obvious that the sooner the disease is defined, the better and quicker the overall result of the treatment will be. Thus, there are three main stages of Lyme disease. The third one is considered to be the most hazardous, as it involves neurological aspect and concerns numerous nervous system diseases and dysfunction. Typically, Lyme disease is treated with the help of antibiotics. Nevertheless, the paper demonstrated the importance of utilizing physical therapy and practice, as it not only has beneficial effects on patient’s health and nervous system disorder, but also can kill the infection, as the last is afraid of heat. In addition, the research demonstrated that some neurological symptoms do not disappear after the usual course of antibiotics intake, while prolonged treatment will not improve the situation. Therefore, physical therapy is the best option to solve these issues.
The Lyme disease is very dangerous, especially because it involves neurological aspect and affects nervous system of a person contaminated with Lyme disease bacteria. Currently, it is known that the disease is transmitted through a morsel of a contaminated tick. First or preliminary symptoms can encompass pyrexia, migraine, and weariness. An erythema is observed in 70 to 80 percent of infected individuals starting with the location of a morsel following the retention of 3 to 30 days. There are three main stages of Lyme disease, where the third one is considered the most dangerous, as the infection affects the nervous system of a person, resulting in neurological problems, including encephalopathy. Nevertheless, this disease can be treated and medicated. Typically, the earlier a therapy and medication is started after the initial contamination, the sooner and more effective the overall convalescence will be. Such antibiotics as doxycycline and amoxicillin taken orally for about four weeks may speed up the incarnation of the erythema and typically impede such consequent indications as arthritis and neurological issues. Intravenous (IV) antibiotics might be utilized in more complicated cases for treating those people whose nervous system has already been negatively affected. Nevertheless, it is important to understand that antibiotic treatment is not the only treatment, which can be utilized to help patients with Lyme disease. A number of specialists accentuate on the overall promotion of exercising for Lyme patients. Physical practice is very important because it improves health, supports and enhances the immune system of a person and kills Lyme disease bacteria. Because serious workout involves the increase of body heat, the bacteria can be killed, as it is afraid of warmth. Lyme disease is dangerous, however, all hazards can be limited if it is adequately treated and timely outlined and disseminated.