What You Should Know about Neurological Lyme Disease and MS

Coyle Patricia K. Coyle, MD, FAAN, FANA
Director, Multiple Sclerosis Comprehensive Care Center
Syritsyna Olga Syritsyna, MD
Multiple Sclerosis Comprehensive
Care Center

Hearing the words “you have Lyme disease” or “you have MS (multiple sclerosis)” can be quite unsettling. And to complicate matters, when Lyme disease affects the central nervous system, the symptoms can be very similar to MS. So it can be hard to tell the difference to the untrained eye. Many doctors are generalists and not specially trained to diagnose either disease. Dr. Patricia K. Coyle, an expert in neuro-immmunology and nervous system infections, has lectured around the world on both topics. She, along with Dr. Olga Syritsyna, who trained under Dr. Coyle, are both neurologists who specialize in neurological Lyme disease and MS.

What is neurological Lyme disease?
Dr. Syritsyna: First, let’s start with defining Lyme disease. It’s a seasonal tick-borne infection caused by the borrelia burgdorferi bacteria that can affect multiple organs and systems in the body. It’s named after Lyme, CT, where it was first identified in 1975. In about 15 percent of cases, Lyme disease affects the central nervous system. When it does, it is known as neurological Lyme disease. Sometimes, people who think they may have Lyme disease find out they have MS (an immune- mediated central nervous system disorder). Lyme disease as an infection can act to trigger MS attacks. This is why being seen by a neurologist specially trained to know the differences is key.

What symptoms do they have in common?
Dr. Coyle: Neurologic symptoms can develop days to weeks to months after the Lyme agents are inoculated into the skin at the tick bite site. This is the site at which the bull’s eye rash appears. Suggestive symptoms are a headache and stiff neck. Other symptoms may include facial nerve palsy (Bell’s palsy), blurred or double vision, spine pain, confusion and fatigue. Neurological Lyme disease may also affect one’s thinking, memory and ability to process information. Some of these symptoms are also common to MS.

Who is at risk for neurological Lyme disease or MS?
Dr. Syritsyna: The majority of people who develop neurological Lyme disease become ill during the summer months. The blacklegged ticks that cause Lyme disease live in moist and humid environments, in and near wooded or grassy areas. To decrease your risk of getting Lyme disease, a few simple precautions can help: Cover up. Use insect repellents. Do your best to tick-proof your yard. Check yourself, your children and your pets for ticks. Don’t assume you’re immune. Remove a tick as soon as possible with tweezers. 
Dr. Coyle: Ninety percent of people who are diagnosed with MS develop it between the ages of 15 and 50, but it can occasionally strike those both younger and older. MS is more common in women (currently there is a 3:1 ratio). Vitamin D deficiency, smoking and having had mononucleosis all increase one’s risk for MS. It’s primarily a Caucasian disease; however, the number of women of color with MS is increasing. There are low-, medium- and high-risk zones and Northern Europe, Canada and the US are three examples of high-risk zones for MS.

Why choose Stony Brook for diagnosis and treatment?
Dr. Syritsyna: Stony Brook has extensive experience in detecting antibodies to B. burgdorferi. We do frequent lumbar punctures (spinal taps) and perform a variety of tests on cerebrospinal fluid.
Dr. Coyle: With MS, we’ve seen the best long-term outcomes when treatment is started early. We now know that ongoing, accumulating permanent damage in untreated patients occurs even when there are no symptoms. This makes early diagnosis and a long-term plan to manage the disease essential. MS treatment at Stony Brook occurs on many levels: disease modifying therapies, symptom management, treatment of acute attacks, ongoing health evaluations, lifestyle modifications and more. At the MS Comprehensive Care Center, we also offer infusion therapy when a patient’s condition can’t be effectively treated by medications taken by mouth (orally). An infusion of a drug is typically administered intravenously (into the veins). As part of an academic medical center, our patients also have access to many ongoing clinical research trials for MS — a number of which have been developed right here at Stony Brook and can be viewed at: bit.ly/MSclinicaltrials.stonybrookmedicine.edu

To make an appointment with a neurologist trained in both neurological Lyme disease and MS, call (631) 444-MSCC (6722) neuro.stonybrookmedicine.edu/mscc