I had an MRI in 2010 (following the birth of my second child) that showed some lesions. The neurologist at the time ran a lyme test but I guarantee it wasn't with IgeneX and said it was negative. I asked what the lesions were from and I never received a straight answer.
I am worried I have lyme disease based on symptoms that wax/wane but when they are here are very real and very painful. If you have lesions in an MRI, does that mean it has crossed the blood/brain barrier?
The MRI was on a 1.5T in 2010:
The ventricular system is normal in size and configuration. The long TR images demonstrate an approximately 10 mm x 2 mm linear focus of increased signal intensity within the posterior left temporal lobe subcortical white matter and a second 4 mm rounded focus of increased signal intensity in the left periatrial white matter. Similar findings were present on the previous study.
There also appear to be a few subtle 1-2 mm punctate foci of increased signal intensity scattered throughout the subcortical white matter of both cerebral hemispheres. In retrospect, these were probably also present on the previous study but are better demonstrated on todays examination due to technical differences between the studies. There is no brain edema or restricted diffusion.
No mass lesion or extraaxial fluid collection Is present. Gray-white matter differentiation is normal throughout the brain. The basal ganglia, thalami, brainstem, cerebellum, pituitary gland, cavernous sinuses, and craniocervical junction appear normal. There is no abnormal enhancement of the brain parenchyma, meninges or cranial nerves. A normal flow void is present within the basilar and both distal intemal carotid arteries, as well as the dural venous sinuses. There is minimal patohy mucosal thickening within the maxillary and ethmoid sinuses; otherwise the paranasal sinuses and mastoid air cells appear clear.
1. No significant interval change in the appearance of the brain when compared to the previous study of June 2010.
2. There are a few small high T2 signal intensity foci scattered throughout the cerebral white matter, as described above. The appearance and distribution of these lesions is nonspecific in nature with the most likely etiology being areas of gliosis related to previous ischemia or inflammation. Clinical correlation is necessary in order to exclude other possible etiologies such as demyelinating disease, LYME DISEASE, or vasculitis. There is no related brain edema, restricted diffusion or enhancement to indicate acute infarction or other active process.
To my non-medical understanding, an MRI is not particularly useful in diagnosing or in ruling out Lyme disease. My LLMD had a SPECT scan done on me, which looks for areas of low blood flow due to swelling caused by Lyme. An MRI does not measure swelling in the brain, but docs who are not familiar with Lyme's effect on the brain tend to reach for the test they know best -- an MRI. To my hazy understanding, I would not worry much about the MRI, but would see an LLMD and take the MRI results with you just in case it's useful, and to ask the LLMD if s/he sees anything there worth pursuing. But don't lose sleep over it in the meantime. I wouldn't.
About blood/brain barrier questions, I did a little quick reading, and to my vague understanding it looks like Lyme can produce more 'brain fog' symptoms when Lyme is in the brain, as one might expect, but it's not something to get overly concerned about, because Lyme is treatable.
Lyme is a spirochete, a spiral-shaped bacterium, just like the bacteria that cause syphilis. Before penicillin (nearly a hundred years ago), syphilis could result in dementia when the bacteria entered the brain and nervous system, but Lyme and syphilis are both curable with antibiotics.
So I wouldn't worry over whether Lyme has or hasn't gotten to your brain ... I was pretty brain-foggy for quite a while, but I'm fine now -- at least I'm no dumber than I used to be!!!
Do ask your doc, but in the meantime try not to worry. (Anxiety IS a symptom of Lyme ... it's the infection messing with the endocrine system, so cut yourself some slack if you're feeling anxious. It will go away when Lyme is treated. Been there, done that, it's over.)
PS One more thought on the anxiety ... are you taking magnesium supplements? Lyme uses up magnesium (Mg) in its reproductive process (ewwww) and can leave you deficient, which results in ... anxiety.
I've also read that the American diet is often deficient in Mg, so with the Lyme stealing what's left, the poor human can end up with levels too low.
I started taking Mg supplements when I was ill, and it was VERY helpful -- sleep was better, mood improved, things were just on a better level.
I still take Mg supplements, and I can see the difference if I run out of it. Any variety ending in "-ate" is supposed to be the easiest to absorb. I have taken Mg malate, and for a while took a blend of Mg citrate, aspartate and orotate, called Magnesium CAO on the brand label.
I had a doc sneer at me once when I told him I was taking Mg supplements, and he said I would damage my kidneys. I looked it up, and I read that if you're in that danger zone of harming your kidneys, then you'll get diarrhea first from the Mg levels being too high. I'm very sensitive to nearly all meds and supplements, and I never had any problems take Mg at the rate of 200mg twice a day (total: 400mg/day). I'm still taking it, and I feel better when I do.
I think it has all been said, but I echo that it is my understanding/experience that Lyme and co-infections may or may not show up on MRI, and that MRI is not a primary diagnostic tool for Lyme.
For what it is worth, I had a very similar MRI report, and for awhile my larger 2 lesions were of concern for MS. It sounds like this was a repeat MRI and that there were no changes, which is very good. My MRI did not change and the lesions never enhanced with contrast, which helped to rule out MS.
I've read of lots of folks with terrible neuro-Lyme systems with perfectly normal MRI's, so it really does not seem to be that helpful a test other than to rule out things like MS.
I never had a SPECT scan either, but have also read that they are of more use in tracking Lyme disease than MRI is.
Unlike SPECT and PET images which assess brain function, MRI captures the physical structure of the brain. Inflammatory abnormalities in the brain are also assessed with MRI scans. In children with neurologic Lyme disease, the MRI may reveal white matter hyperintensities suggestive of inflammation or areas of demyelination. Up to 40% of adults with Lyme disease may also have small white matter hyperintensities, but it should be noted that the number of hyperintensities increase with age – even among patients who do not have Lyme disease. In addition, certain factors such as ischemic disease or a history of smoking may result in an increased number of hyperintense areas.
The white matter hyperintensities are sometimes called UBOs or "unidentified bright objects". In some patients, antibiotic treatment results in a diminution or disappearance of these hyperintensities. Certain MRI sequences, such as FLAIR, are best able to detect hyperintensities. These MRI images in Lyme Disease may appear similar to the demyelinated areas seen in the "white matter" of the brain MRI of patients with multiple sclerosis. The brain MRI of the young patient at the left revealed MS-like lesions in this individual with a fully positive IgG Lyme Western blot indicating immune reactivity against the agent of Lyme disease. Because an MRI scan uses a very powerful magnet, patients with pacemakers or other metallic implants should not get an MRI."
There's more on that site about SPECT imaging.
There are universities in FL which do SPECT imaging.
University of South Florida
University of Miami Miller School of Medicine
--- are just two of them.
But whether or not they are experienced with Lyme, I don't know. And I imagine that it would depend on your doctor being affiliated with that hospital. A lot of 'ifs'.
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