Lyme Disease Identified in Patients With Chronic Post-Concussion Syndrome

Researchers at the Azzolino Clinic in San Francisco, California, identified what they
describe as “an alarming number of individuals suffering from post-concussion syndrome
(PCS) that are refractory to care and that have serologically tested positive for Lyme
disease.”

“Furthermore, we have witnessed a dramatic improvement in function and reduction in
disability following treatment of these patients,”

writes Azzolino and colleagues.

Why Consider Lyme Disease in Chronic PCS?

Based on these clinical observations, the authors asked an important question:
What is the prevalence of Lyme disease and associated co-infections in patients with
post-concussion syndrome who remain symptomatic at least one year after traumatic brain
injury?

They further questioned whether ongoing symptoms could be explained by
“an undiagnosed and untreated Lyme disease or associated co-infection,” rather than
persistent brain injury alone.

Study Design and Inclusion Criteria

The authors identified 217 patients with chronic PCS who had not responded to standard
treatment for traumatic brain injury and who tested positive for Lyme disease by IgM
Western blot through IGeneX laboratory testing.

To be included in the study, patients were required to have at least one PCS symptom—such
as headache, irritability, dizziness, vertigo, or difficulty concentrating—for more than
one year following injury, along with a normal brain CT or MRI scan.

Patients were excluded if they had previously tested positive for Lyme disease or
co-infections, had received at least two weeks of antibiotics since the date of injury,
had a primary neurologic diagnosis such as multiple sclerosis or seizure disorder, or had
post-stroke syndrome.

[bctt tweet=”Study examines the prevalence of Lyme disease in patients with post-concussion syndrome who do not respond to treatment.” username=”DrDanielCameron”]

Key Findings

Among the 217 patients studied, 38% had a positive IGeneX IgM Western blot for Lyme disease.

“There was a statistically significant relationship of a positive Western blot IGeneX IgM
predicting chronic PCS,” Azzolino writes.

The authors suggest that antibiotic treatment for Lyme disease
“could also alleviate symptoms such as cognitive disturbances, dizziness, and fatigue” in
this patient population.

They further note that, “Given the cost of interventions for PCS, the diagnosis and
treatment of co-morbid infections could prove to have a significant impact on the standard
of care of PCS.”

Important Limitations

Editor’s note:
This study is limited by its reliance on an IgM Western blot from IGeneX laboratory and the
absence of confirmatory IgG Western blot testing. The findings require further replication
and validation in independent cohorts.

Nevertheless, the study raises important questions about whether persistent symptoms in
some patients diagnosed with post-concussion syndrome may reflect an underlying,
potentially treatable infectious process.