NBC TODAY covers Lyme disease

March 10, 2009 The tradegy death of a pastor had in Illinois has led to a national Lyme disease dialogue regarding the psychiatric manifestations of Lyme disease.

The man charged with murdering the paster reportedly suffered from Lyme disease.  Dr. Brian Fallon, head of the Columbia University Medical Center's Lyme and Tick-Borne Diseases Center, has described psychiatric manifestations of Lyme diease in th early 1990's.  Brian Fallon, had described psychiatric manifestations in his recently published National Institutes of Health (NIH) trials.  "Many of my Lyme disease patients experience anxiety, panic, rage, and depression during their illness," according to Dr. Daniel Cameron, President, International Lyme and Associated Diseases Society (ILADS) 

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Tragically the death of a paster, several parishoners and arrest of a Terry Joe Sedlacek in Illinois had brought the psychiatric manifestation of Lyme disease to national attention.  Terry Joe Sedlace had been suffering from Lyme disease according to a feature article in the St. Louis Post-Dispatch on 8/6/08 titled Lyme disease diagnosis can be difficult by Greg Jonsson.  The story begins as "Terry Joe Sedlacek's parents worried that he was getting into drugs or alcohol when he started acting strangely during his junior year at Edwardsville High School. He dropped out of the activities that used to interest him. He seemed confused. He missed class, and one time when the school called his mother, Ruth Abernathy, to say he hadn't shown up, she found him home on the couch, having forgotten he was supposed to be somewhere else." 

Sedlacek's condition had been intially diagnosed and treated as a mental illness "Doctors diagnosed him as mentally ill and for years he took medicine - up to 18 pills a day at one point. But the drugs that worked for others seemed to do little for him. His physical condition deteriorated, too, and in 2003 he was in the hospital, so sick he was given last rites.  Finally a desperate battery of tests for everything from West Nile to SARS pinpointed two tick-borne diseases: Lyme disease and ehrlichiosis."

Sedlacek was reported to have "difficulty speaking. He's got lesions on his brain. He's taking several drugs, including anti-seizure medication."  The outcome of treatment was mixed.  See the entire 8/6/08 story from the St. Louis Post-Dispatch. 

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Three experts and the CDC Web site were cited by the AP author, Lindsey Tanner downplaying the psychiatric manifestations of Lyme disease. Fortunately, Lindsey Tanner closes with a more balanced discussion of the psychiatric manifestations of Lyme disease.  The text to the AP piece had been attached for discussion and comment.

The mother of a man charged in the Sunday shooting death of a church pastor blames Lyme disease for his mental problems. However, leading disease specialists say there's no convincing evidence linking the tickborne ailment to such violent behavior.

"Lyme disease doesn't cause people to shoot people," said Dr. Eugene Shapiro, a Lyme disease specialist at Yale University.

He recalled an ax attack in Connecticut in which the perpetrator "pleaded Lyme disease defense. That didn't fly."

The most common Lyme symptoms, caused by bacteria spread by the tiny deer tick, include a bullseye-shaped skin rash and fever. Most people recover with antibiotics, although some symptoms can persist.

According to the federal Centers for Disease Control and Prevention's Web site, Lyme disease can spread to the bones, heart and nervous system if not treated. It can cause brain inflammation and in rare cases, problems with concentration, short-term memory and sleep disturbances.

Sometimes there is severe headache and neck stiffness, which can be treated by antibiotics, Shapiro said.

Occasionally, nervous system problems can develop months or even years after a tick bite, including irritability and nerve damage in the arms and legs, according to the National Institutes of Health.

But Shapiro said that while there are isolated reports of hallucinations and psychotic illness blamed on Lyme disease, these are controversial. He said these cases likely involve people with pre-existing mental problems or who were misdiagnosed and never had Lyme disease.

Some patient-advocacy groups use the term "Lyme rage" to explain aggressive psychiatric symptoms. Dr. Paul Auwaerter, an infectious disease specialist at Johns Hopkins medical school, noted that the condition was even implicated in a highly publicized chimp attack last month that severely injured a Connecticut woman; the animal was said to have Lyme disease.

But at least in humans, mental illness is much more common than Lyme disease, and it would be "extraordinarily rare" to develop a true psychosis from the disease, Auwaerter said.

Dr. Gary Wormser, infectious diseases chief at New York Medical College in Valhalla, said he has done research showing that in areas where the Lyme tick is rampant, psychiatric patients are not more likely than other people to have Lyme disease.

Auwaerter said believers tend to be community doctors in the trenches — primary care physicians in areas where Lyme ticks are prevalent and who diagnose Lyme disease based on symptoms rather than blood tests.

These include Dr. Daniel Cameron, an internist in Westchester County, New York, where Lyme disease is common. Cameron is president of the International Lyme and Associated Diseases Society, a group of mostly primary care doctors.

He said he has had many patients with Lyme disease who complain of psychiatric problems, including anxiety, panic and aggression. Some, usually young people, have resorted to violence including hitting family members, he said.

He defended diagnosing patients based on symptoms, saying blood tests aren't perfect. And, Cameron argued, research suggesting there is no link is not strong enough "to dismiss the medical and psychiatric issues that we see in our practices."