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1. Lyme Disease in Autism: Diagnosis and Treatment Options Introduction Inflammation/ oxydativestress Diagnosis Disease paradigm Antibiotic Treatment Naturopathic approaches A parent perspective • www.autismtreatmenttrust.org • www.loreneamet.net

2. Lyme Disease Agents USA: Essentially Borrelia burgdorferi. Europe: B. afzelii, B. garinii, B. burgdorferi, and occasionally other species of borrelia Scanning electron micrograph image of Borrelia burgdorferi. Image-Wadsworth Center, New York State Department of Health Lyme disease is spread by the bite of ticks of the genus Ixodes (deer tick) that are infected with Borrelia burgdorferi.

3. Life cycle of Borrelia is linked to the tick life cycle Two Year Life-Cycle Deer Tick

4. Reported Cases of Lyme Disease—United States, 2010. Source CDC

5. Lyme Disease Symptoms Early Symptoms (Acute) Late Symptoms (Chronic) “The Great Imitator” Common symptoms: Profound fatigue Chills, sweats ad skin flushes Migrating arthralgia Muscle pain/ twitching Severe headaches Tremors Numbness/ Tingling sensations, pain shifting Cranial nerves disturbances Cont... Erythema migrans seen in 50% of people Less frequently still in EU

6. Lyme Disease Symptoms Cont. Neurological symptoms associated with late stage Lyme disease: Progressive dementia Seizure disorders ALS-like symptoms (similar to Lou Gehrig’s disease) Gillian-Barre-like symptoms Multiple Sclerosis-like symptoms Parkinson’s disease-like symptoms Other extrapyramidal disorders Visual disturbances or loss Loss of attention/ executive functions, auditory and mental tracking and memory retrieval. These will impact on: Memory functions Language functions Visual and spatial processing Abstract reasoning Processing speed

7. Systemic inflammation The prolonged immune response, trying to fight Borrelia burgdorferi infection, causes most of the symptoms of Lyme disease, including joint inflammation, skin changes, and neurological problems.

8. Spirochete and colony-like Borrelia forms Characteristic morphology of Borrelia burgdorferi (Dark field microscopy images of Borrelia burgdorferistrain B31 showing the usual spiral form of spirochetes (A) and their agglomeration into colony-like masses (B)

9. Cystic Borrelia forms Rolled and cystic forms of Borrelia burgdoferispirochetes observed after one week of culture in medium to which Thioflavin S had been added.

10. Intracellular and cystic Borrelia forms Atypical and cystic Borrelia forms following 1 week exposure of primary neuronal and astrocytic cultures to Borrelia burgdorferi.  C: OspA positive Borrelia spirochetes closely surrounding neurons (strain B31). D: Atypical filamentous and ring-shaped cystic, apparently intra-cellular spirochetes in a neuron (strain B31).

11. Systemic Inflammation in Lyme’s Disease Chronic neuroinflammation in the frontal cortex of a patient with Lyme neuroborreliosis. First column (A, D and G): Accumulation of HLA-DR (A) and CD68 (D) immunoreactive microglia forming clumps, and GFAP (G) positive large reactive astrocytes in the frontal cortex of a patient with Lyme neuroborreliosis.

12. Systemic inflammation in Autism

13. Diagnosis of Lyme 1- Detection of Borrelia agents PCR, Serology and Elispot 2- Co-infections: Ehrlichia, Babesia, Bartonella, Yersinia, Toxoplasmagondii, Anaplasmaphagocytophilum, and other potential infections that can affect health: Streptococcus A, Chlamydia, Mycoplasma, Borrelia burgdorferi 2- Clinical symptoms of chronic infection Sweating, excessive thirst, level of activity, fatigue, body temperature regulation issues, muscle tones, skin flushing, rash, motor and cognitive functions, pain, hearing sensitivity. 3- Complementary lab work Natural Killer cell counts: NK1, NK2, NK3 Complete blood count Inflammation Markers Auto-immune issues Liver/ Kidney function Nutritional markers Hormonal profile

14. The Lyme War Infectious Diseases Society of America (IDSA), American Academy of Neurology, Centers for Disease Control and Prevention NIH, NHS: Chronic Lyme does not exist. Advise against long-term antibiotic treatment. No other treatment considered. International Lyme And Associated Diseases Society (ILADS): Symptoms of Chronic Lyme are real and associated with remaining Borrelia Long-term treatment of infection is required.

15. Treatment Options General points Remove Stressors GF/CF –SCD- Sugar etc. Allergens Toxins Optimal metabolism & physiology Nutrition Digestion Immune system Liver & kidney functions Hormonal Treat the Infection Three Borrelia stages to consider & Potential co-infections

18. Example of antibiotic regimen

20. Heirxheimer reaction proves that inflammation causes a wide range of behavioural and health Disturbances Cholestyramine- Questran ideally version without Aspartame Activated charcoal Aspirin Hydrocortisone (100mg) During AB treatment Prednisolone during AB treatment Systemic Enzymes e.gWobenzymes Breaks in treatments Sauna/ detoxification

21. Other problems associated with prolonged antibiotic use • Yeast and clostridia flare ups • Liver and kidney function • Heart • Eye sight • Drug-drug interaction

23. Buhner’s protocol Kalmegh, Lycopodiumclavatum  also used for epilepsy, Periwinkle (vinpocetine) (V minor, V major), cerebral blood flow and cognitive function. Red Root (Ceanothusamericanus or equivalent) Artemesinin (Artemisia annua), Autumn crocus (Colchicum autumnale) surijan-i-talkh etc.

24. Alternative Treatment Options? Electromedicine –Rifle machine Mortar Oscillatory Rate (MOR)