Post Lyme Disease Syndrome

Some people may continue to experience the symptoms of Lyme disease even after the disease has been treated. In general, this is called post-Lyme disease syndrome. Why it happens to some people is poorly understood. Adding to the confusion is that doctors and researchers are still defining what it means to have post-Lyme disease syndrome.

Here's one definition of the disease, published in a 2006 edition of the journal Clinical Infectious Diseases. Aspects of this definition are controversial and not entirely accepted by the medical community.

Criteria of Post-Lyme Disease Syndrome

According to the authors of the journal article, in order to be diagnosed with post-Lyme disease syndrome, the following criteria must be met:

• A prior case of Lyme disease, confirmed by a physician. This seems obvious, but many people believe they have had Lyme disease without having had any of the symptoms or laboratory tests to diagnose the presence of Lyme disease.
• Lyme disease has been treated by a physician using generally accepted treatment guidelines.
• The patient has had one of the following symptoms after getting Lyme disease, and for at least six months after treatment:
  • Fatigue
  • Aches and pains in the muscles and joints throughout the body.
  • Difficulty concentrating, short-term memory loss or other difficulties thinking
  • These symptoms are so severe that normal activities of daily life are impaired
• The patient does not have other diseases, such as another tick-borne disease like babesiosis, or other diseases, such as chronic fatigue syndrome or fibromyalgia, that were diagnosed before Lyme disease.
• The patient does not have measurable signs of active Lyme disease (see the symptoms of Lyme disease and diagnosing Lyme disease).
• The patient has not had laboratory tests showing other disorders such as high erythrocyte sedimentation rate, abnormal thyroid function, and other abnormal results in routine blood and urine tests. A high erythrocyte sedimentation rate or abnormal thyroid function tests are probably caused by other diseases.

Along with those criteria, the researchers listed the following common disorders, which some find particularly frustrating, especially if they are convinced they have post Lyme disease syndrome. Many other diseases besides Lyme disease must be considered so that people get the proper treatment for their symptoms. Given the common nature of the symptoms described in post Lyme disease syndrome, doctors may look for any other diagnoses that could account for such symptoms including:

• Obesity, sleep apnea, or narcolepsy.
• Side effects of medications or an autoimmune diseases.
• Uncontrolled heart, lung or endocrine disorders, or cancer (except uncomplicated skin cancer) for more than two years.
• Liver disease.
• Depressive disorders, bipolar disease, schizophrenia, delusional disorders, dementia or eating disorders such as anorexia or bulimia, or active drug abuse or alcoholism.

_Sources

Chin, J. (2000.) Control of communicable diseases manual. Washington D.C.: American Public Health Association.

Centers for Disease Control. Division of Vector Borne Infectious Diseases. Lyme Disease. Learn About Lyme Disease.

Wormser, G. P. (2006). The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clinical Infectious Diseases, 43, Retrieved April 15, 2007.