Thursday, July 31, 2008

Parkinson's

I have a patient who developed frightening symptoms of Parkinson's disease while on anti-Lyme therapy. I took her off antibiotics and she got better. By the time she saw the neurologist she was better so he called it psychogenic. She was then able to tolerate lower doses of antibiotics with the symptoms returning. Michael J Fox got Parkinson's after a bout of Lyme disease. I have several other patients who have developed Parkinson's, at a young age, apparently from Lyme disease. I have found that treatment is of little help. Patients may stabilize but they do not improve once the disease has progressed. Parkinson's is associated with damage to a part of the brain called the substantia nigra in the basal ganglia, a deep part of the brain's white matter. Once the damage is done the disease is permanent. Apparently if the disease is treated very early, as in this case, Parkinson's may be prevented. Comments are welcomed.

5 comments:

consilience said...

A friend of mine had received both a Parkinson's and an ALS diagnosis before realizing that active Bb, Cpn, and co-infections were present. I was very interested to read Dr. David Martz' story in Pamela Weintraub's book "Cure Unknown - Inside the Lyme Epidemic". He had severely debilitating symptoms and was diagnosed with ALS, and yet after long term antibiotics he recovered enough to start treating patients again. Dr. Martz also talks about his story in the documentary film "Under Our Skin". (I purchased a copy of the DVD at www.underourskin.com for $35.) A patient with a Parkinson's diagnosis is also interviewed in the film. I don't know enough about the connection between ALS and Parkinson's, but I sure hope there's help in treatment for either diagnosis.
Thank you for this blog.

Lyme report: Montgomery County, MD said...

Unfortunately, Dr. Martz had several heart attacks and no longer sees patients. I treat one of his former patients. My experience is that ALS type symptoms improve, MS symptoms improve or stabilize but that Parkinson's features are more resistant to treatment. More recently I had some results with adding Amantadine to the regimen and saw improvement in al least one patient. Dr. Burrascano and Dr. Donta have recommended Amantadine as an adunct to Biaxin and Zithro. They say it can be used in place of plaquenil. Amantadine has a history of use with Parkinsons symptoms and MS for fatigue. It is also an antiviral drug which can work against HHV6. This is a very neurotropic virus which essentially everyone has been exposed to. Lyme can cause multiple neurological syndromes. It is hard to predict how it will affect an individual. There is no direct connection between ALS and Parkinson's. ALS occurs because of damage to motor neurons. Parkinson's occurs because of damage to a deep part of the brain called the basal ganglion. The role of CPN is up for debate. AlS/Lyme has been treated with IV Rocephin, Zithromax and Flagyl. CPN treatments are more complex, but require at least Rifampin as well. The Parkinson's will require standard drugs like Sinemet and Requip or Mirapex. Amantadine should be considered. Care must used in adjusting antibiotic doses. Dr. Martz's experience was that ALS type patients could experience a severe "neural Herx" which could cause permanent neurological damage. My former Martz patient also saw Jemsek, who is featured in the film. He added Cleocin. He is the only LLMD that I know of who recommends this drug. When I recently increased the dose it seemed to help. These cases are tough and require caution. Babesia needs to be considered. There are no good tests for it. In "Cure Unknown" it is reported that Martz first got better with Malarone, an antimalarial drug which hits Babesia. You need a doc who can juggle all of this and step outside the box. Good luck!

Itsy_bitsyone said...

Hi Doc..

I know everyone is different. I am a 37 year old woman a bit away from you in Garrett County. I got Lyme when I lived in NJ and like many others went decades without diagnosis. On top of that I may also have Ehler's Danlos Syndrome, a genetic hypermobility disorder.

I still have a little tremor, but a few months off a year on and off of Doxy followed by tetracycline then minocycline, the narcolepsy w/cataplexy is gone. The tremor is greatly improved. My arms swing when I walk. A few months ago my doctor was talking about sending me to Dr. Katz because she didn't know what to do. So I took a break from the Mino (I needed a break and figured if I had parkinson's it wouldn't matter anyway) and now I feel better than I have in years.

It took a few months and a LOT of patience after antibiotics to start feeling better. Will I relapse? I don't know.

My knees are trashed (still red, still large), I have other arhtritis from being hypermobile and I dislocate and sublux easy and have pretty bad degenerative disc disease that started in my 20's. Many joint issues, its hard to know where lyme begins and ends. (I do have textbook "steere-knees". That has not changed in a year. Ultram helps the pain.

Mino was the best for me neurologically. Now, some people seem to have severe reactions...the trick was to start reaaaaal slow and increase. Mix in some diflucan now and then for the candida some probiotics and protonix (was essential for me)...and as long as my doc allowed me to manage my dosage to what I could tollerate I did well.

Are we sure that it is 'true' damage to the basal ganglia, etc in Lyme....OR could be be just a hypocretian deficiency?

Nancy
tinysmalllittle@yahoo.com
www.myspace.com/tinysmalllittle

Lyme report: Montgomery County, MD said...

Minocin has special neuroprotective benefits.
Whether Parkinson's persist may have a lot to do with stage of the disease. Minocin can cause a Herx and exacerbation so it makes sense to start low and gradually ramp up. The role of Diflucan is not known. Why protonix?

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