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Is Basal Ganglia Hyperintensities A Symptom Of Lyme Disease?

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Posted on Sat, 8 Aug 2015
Question: I have had lyme disease for approximately 23 years and just had an MRI of the brain and it showed hyper intensities basal ganglia of the brain. Is this related to lyme?
My email is YYYY@YYYY Also I have all the symptoms of late stage lyme. I have constant pain, short term memory loss, am blacking out (cannot drive), sleeping a lot, depression, sensory overload, make a lot of errors (checkbook, numbers, etc.), problems with balance, central nervous central system damage, etc.
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Answered by Dr. Olsi Taka (47 minutes later)
Brief Answer:
Lyme encephalopathy is possible.

Detailed Answer:
I read that report carefully and I understand your concern.

Regarding the basal ganglia hyperintensities I think that while it is possible it is not that likely to be due to Lyme. That is because when Lyme affects brain matter it is usually the white matter in the periventricular areas. There is also usually involvement of one or more cranial nerve and/or the meninges.
Basal ganglia changes may be related to many other causes such as calcifications, hypoxia/hypotension episodes, carbon monoxide poisoning, vasculitis due to other causes such as lupus, hypothyroidism, parathyroid dysfunction etc.

Anyway whether the hyperintensities themselves are due to Lyme or not, looking at the description of your symptoms which I see you've added now, there is the possibility of Lyme being the cause of those symptoms. Lyme encephalopathy is a condition which can manifest years later and can include all those symptoms that you describe. In that case you would need again a course of iv antibiotics.
However there should be considered other possibilities like depression and anxiety associated with post-treatment Lyme disease syndrome, a syndrome described in many patients with fatigue and muscle aches, which can be mistaken for encephalopathy but doesn't benefit from antibiotic treatment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Is Basal Ganglia Hyperintensities A Symptom Of Lyme Disease?

Brief Answer: Lyme encephalopathy is possible. Detailed Answer: I read that report carefully and I understand your concern. Regarding the basal ganglia hyperintensities I think that while it is possible it is not that likely to be due to Lyme. That is because when Lyme affects brain matter it is usually the white matter in the periventricular areas. There is also usually involvement of one or more cranial nerve and/or the meninges. Basal ganglia changes may be related to many other causes such as calcifications, hypoxia/hypotension episodes, carbon monoxide poisoning, vasculitis due to other causes such as lupus, hypothyroidism, parathyroid dysfunction etc. Anyway whether the hyperintensities themselves are due to Lyme or not, looking at the description of your symptoms which I see you've added now, there is the possibility of Lyme being the cause of those symptoms. Lyme encephalopathy is a condition which can manifest years later and can include all those symptoms that you describe. In that case you would need again a course of iv antibiotics. However there should be considered other possibilities like depression and anxiety associated with post-treatment Lyme disease syndrome, a syndrome described in many patients with fatigue and muscle aches, which can be mistaken for encephalopathy but doesn't benefit from antibiotic treatment.