Diagnostic and Therapeutic Challenges in Lyme Disease and Co-Infections: Unraveling Neuropsychiatric and Neurological Complexities-A Comprehensive Case Series Analysis.

Abstract

Background/objectives: Lyme disease (LD) and its co-infections present significant diagnostic and treatment challenges due to their complex interplay with neurological symptoms, immune responses, autoimmune reactions, and mental health conditions. Standard two-tier LD testing often fails to detect cases, necessitating expanded serologic and functional testing. Following CARE Guidelines, this case series examines ten clinical narratives of LD, highlighting the limitations of standard diagnostic methods, the potential benefits of specialized testing, and the need for an effective paradigm for LD management.

Methods: A multidisciplinary approach grounded in integrative medicine was adopted. Diagnostic methods included advanced serological panels (e.g., TICKPLEX^®), co-infection testing, functional immune markers, Cunningham Panel testing for neuropsychiatric Lyme presentations, and imaging. Treatments included traditional antibiotics, botanical antimicrobials (Cryptolepis, Artemisinin, Biocidin), mitochondrial and neuroprotective support (CoQ10, NAD+, magnesium), nutritional therapies, detox support, immune system support protocols, pulsed electromagnetic field therapy, and methylene blue protocols.

Results: The findings from this case series demonstrate the heterogeneity of LD manifestations across different ages, genders, and backgrounds. Compared to promising specialized testing, standard laboratory tests often misdiagnose LD and its co-infections as Parkinson's disease, multiple sclerosis, lupus, autism, and psychiatric disorders. Furthermore, integrating diverse treatment modalities, including combination and rotational antibiotic therapy, IV ceftriaxone for neurological cases, detoxification support (glutathione IV, vitamin C IV), and immune modulation with intravenous immunoglobulin, helped manage symptoms. Herxheimer reactions were effectively managed with antioxidant and detox therapies. Patients receiving long-term maintenance therapies, including herbal antimicrobials and gut microbiome support, showed fewer relapses.

Conclusions: This case series advocates for a holistic, patient-centered approach. It emphasizes the necessity of comprehensive diagnostics that consider external factors, including post-vaccine symptom exacerbations, immune dysregulation, personalized treatment strategies, and ongoing research to improve LD management. These findings provide an evidence-based framework for physicians to integrate conventional and natural medicine strategies to optimize LD care.