Wednesday, July 2, 2008

ALS: A patient

I have a wide variety of patients in my practice who come with fascinating stories. Some of these patients have been around the block and recieved treatment by some of the top Lyme specialist in the country. One such patient suffers with Lyme complicated by an ALS like syndrome. The primary manifestations of this disease are muscle weakness and atrophy which without treatment have in the past usually been progressive and fatal. This patient was formerly treated by Dr. Martz, the physician who himself was cured of Lyme induced ALS and had created a clinic to specialize in this disorder. Unfortunately, Dr. Martz closed his clinic for health reasons unrelated to Lyme. His patients have been scattered to the four winds seeking out physicians willing to continue their care.

This patient had been stabilized on a combination of IV Rocephin and Zithromax, both used at a low dose. Higher doses in the past had caused brain Herx reactions which exacerbated her symptoms. She also was on Tindamax and Cleocin. The Cleocin had been prescribed by Dr. Jemsek. Dr. Jemsek may be the only Lyme doc in the country who routinely uses Cleocin. He has found this drug to be effective for many patients.

I have made some minor adjustments in her medication regiment and she seems to be improving somewhat. Options may include: Adding Rifampin, gradually increasing the IV meds and a trial of Lithium. A recent publication suggests that Lithium may be helpful in ALS. Interestingly, other sources have suggested that Lithium is helpful with other forms of neurological Lyme disease.

1 comment:

Cary said...

And what happened to this ALS patient? How are they doing today October 2010? Looking for people with als symptoms and Lyme who are doing better. Please let me know how this person is doing now?