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MOTOR NEURON, ALS, LYME DISEASE

Posted Nov 30 2012 11:03am

Despite that future research is still needed, some data of the literature suggest a possible relationship between ALS and Lyme disease.

References with respect to ALS and Borrelia burgdorferi
Lancet. 1987 Aug 8;2
(8554):332-3.
Borrelia burgdorferi antibodies and amyotrophic lateral sclerosis.
Waisbren BA, Cashman N, Schell RF, 
Johnson R.
Muscle Nerve. 2009 Oct;40(4):626-8.
Lyme disease serology in amyotrophic lateral sclerosis.
Qureshi M, 
Bedlack RS, Cudkowicz ME.
Source
Neurology Clinical Trials Unit, Massachusetts General Hospital, Harvard Medical 
School, 13th Street, Building 149, Room 2274, Charlestown, Massachusetts 02129, USA. mqureshi@partners.org
Abstract
Lyme disease is sometimes part of the differential diagnosis for amyotrophic lateral sclerosis (ALS). Herein we report on 414 individuals with ALS at the Massachusetts General Hospital who underwent laboratory testing for Lyme disease. 
Twenty-four (5.8%) were seropositive, but only 4 (0.97%) had confirmed past immunoreactive infection. Two of these patients received ceftriaxone for 1 month without clinical improvement. Lyme disease was rare in 414 patients with ALS and is not likely to be causative.
Wien Med Wochenschr. 1995;145(7-8):186-8.
[ALS-like sequelae in chronic 
neuroborreliosis].
[Article in German]
Hänsel Y, Ackerl M, Stanek G.
Source
Neurologischen Abteilung des Kaiser-Franz-
Josef-Spitals, Wien.
Abstract
CSF investigation in a 61-year old female patient with clinical picture of motoneuron 
disease gave evidence for chronic infection with Borrelia burgdorferi. Improvement of clinical and CSF findings could be observed after antibiotic therapy. The diagnosis of amyotrophic lateral sclerosis which was initially suspected had to be revised and the disorder was interpreted as chronic neuroborreliosis.
Rev Neurol (Paris). 2006 Jun;162 Spec No 2:
4S50-4S56.
[What is the role of other complementary examination in amyotrophic lateral sclerosis?].
[Article in French]
Tranchant C.
Source
Département de Neurologie, Hôpitaux Universitaires, Strasbourg. Christine.Tranchant@chru-strasbourg.
fr
Abstract
Amotrophic lateral sclerosis diagnosis is based on clinical and electrophysiological findings. Transcranial 
magnetic stimulation and MRI can show abnormalities which are not specific, but which can confirm upper motor neuron involvement. The other tests are performed to exclude differential diagnosis. Tests which should be performed in every cases are: medullar MRI, blood counts, erythrocyte sedimentation, serum protein electrophoresis, calcium, phosphore, 
serological tests for HIV, siphylis, Lyme disease. Other tests are made in some clinical circonstances to exclude genetical disease or metabolic disorders (SMN gene, Kennedy gene, Hexosaminidase A, very long chaine fatty acids), haematological or paraneoplasic disorders (anti-neurons antibodies, PSA, CT of chest and abdomen, mammography, bone 
marrow biopsy) or inclusion myositis (muscle biopsy).
Wien Med Wochenschr. 1995;145(7-8):186-8.
[ALS-like sequelae in 
chronic neuroborreliosis].
[Article in German]
Hänsel Y, Ackerl M, Stanek G.
Source
Neurologischen Abteilung des Kaiser-
Franz-Josef-Spitals, Wien.
Abstract
CSF investigation in a 61-year old female patient with clinical picture of motoneuron disease gave evidence for chronic infection with Borrelia burgdorferi. Improvement of clinical and CSF findings could be observed after antibiotic therapy. The diagnosis of amyotrophic lateral sclerosis which was initially suspected had to be revised and the disorder was interpreted as chronic neuroborreliosis.
PMID: 7610670 [PubMed - 
indexed for MEDLINE]
Arch Neurol. 1990 May;47(5):586-94.
Immunologic reactivity against Borrelia burgdorferi in 
patients with motor neuron disease.
Halperin JJ, Kaplan GP, Brazinsky S, Tsai TF, Cheng T, Ironside A, Wu P, Delfiner 
J, Golightly M, Brown RH, et al.
Source
Department of Neurology, State University of New York, Stony Brook 11794.
Abstract
Of 19 unselected patients with the diagnosis of amyotrophic lateral sclerosis (ALS) living in Suffolk County, New York (an area of high Lyme disease prevalence), 9 had serologic evidence of exposure to Borrelia burgdorferi; 4 of 38 matched controls were seropositive. Eight of 9 seropositive patients were male (8 of 12 male patients vs 2 of 24 controls). Rates of seropositivity were lower among patients with ALS from nonendemic areas. All patients had typical ALS; none had typical Lyme disease. Cerebrospinal fluid was examined in 24 ALS patients--3 (all with severe bulbar involvement) appeared to have intrathecal synthesis of anti-B burgdorferi antibody. Following therapy with antibiotics, 3 patients with predominantly lower motor neuron abnormalities appeared to improve, 3 with severe bulbar dysfunction deteriorated rapidly, and all others appeared unaffected. There appears to be a statistically significant association between ALS and immunoreactivity to B burgdorferi, at least among men living in hyperendemic areas.
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