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Migraines and Lyme Disease
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Migraines and Lyme Disease

I have had migraines for about twenty years. Three years ago I had an MRI of the brain (for benign fasciculations after a viral infection), test normal. A year ago, last summer I was diagnosed with Lyme Disease (early disseminated) and was treated with oral antibiotics for three months (twitching three years ago was wintertime in Connecticut). My most significant symptom was severe headaches with painful neck and shoulder muscles. This past year my headaches were more severe, frequent and prolonged than ever. I treated them with aspirin, and Zomig as a last resort. Again, this summer I presented with Lyme disease symptoms. Doctor said from the test results she could not tell if it was a new infection, or the old flaring up. Went on Doxycycline for thirty days. After three weeks of antibiotic treatment, I began to have bad headaches every couple days for about two weeks. During this last Lyme infection, I also have had very frequent painless (but annoying) back spasms/contractions on my left side under my rib cage. Inernist said she didn't think it is muscular, but probably neurological, related to the Lyme. Does this sound Lyme related to you? Also, could you tell me what further tests you think I should have done to rule out Lyme disease causing the headaches? Two weeks ago, in desperation I began this treatment by this dentist named Dr. Mark Friedman in Scarsdale, NY who just got FDA approval on this oral chilling device to reduce inflammation in the maxillary area and to my total surprise it has been working. Not one headache. Any validity to this, or Just coincidence?
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First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. The symptoms you describe can be attributed to Lyme disease, but there may be other factors contributing to your headaches.  Borrelia burgdorferi (agent in Lyme disease) can cause chronic inflammation in the nervous system that can trigger migraine headaches, cause paraethesias (numb/weird feeling areas) and/or psychiatric/cognitive problems.  To treat nervous system Lyme disease, 4 weeks of IV antibiotics (Ceftriaxone) is generally recommended (but cumbersome).  To evaluate the effect that Lyme disease may be playing into your current symptoms, I would recommend a SPECT scan of your brain.  I would also recommend a lumbar puncture to evaluate for persistent inflammation (cell count, protein, glucose, and tourtelotte panel (IgG index).
   That being said, you should have a ophthamologic exam for papiledema, because doxycycline (and all of the tetracyclines) can cause increased intracranial pressure, which can lead to headaches and permanent visual loss (in severe cases).
  The intra-oral vasoconstrictive chilling device (IVC) is still an investigational device and too little data exists at this time to comment on conclusively.  The theory is that intra-oral inflammation is associated with irritation of the maxillary nerve, which then triggers migraines.  Cooling this area for 40 minutes a session with hollow tubes pumped with ice water is designed to decrease inflammation and help headaches. After the first session an oral anti-inflammatory gel is used. The 2 studies (2001,2004) are very small 30-40 patients and have not been reproduced by independent investigators.  The first study compared the IVC device to sumitriptan and was equally as effective.  Maybe (totaly theoretical) the device works for you because your migraines are caused by chronic lyme related inflammation? If it works for you, I would not argue with success.  The real answer on the efficacy of the IVC device will require a multi-site, high powered (many patients) randomized double blind trial by an impartial moderator (not the owner) (expensive and time consuming).
I hope this has been helpful.
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