From: odp@ldgo.columbia.edu (carl brenner)
Subject: Re: CFIDS and Lyme
Summary: Speculations on Lyme<--> MS
Organization: Lamont-Doherty Geological Observatory
Date: Mon, 31 Aug 1992 19:50:28 GMT

In article <16272@pitt.UUCP>, geb@dsl.pitt.edu (gordon e. banks) writes:
> In article <1992Aug28.162338.10877@equator.com> jod@equator.com (John Setel O'Donnell) writes:
> >    
> >    2.  prior tests in years past for lyme disease have been negative ... all
> >    i can say is that at least people with a lyme disease diagnosis get
> >    respect for living with a serious illness.
> >    
> >Lyme is a clinical diagnosis, and is essentially indistinguishable in
> >symptoms from CFIDS.  Many people (40%) never have the characteristic
> 
> Lyme is a disease with a definitely identified cause (the borrelia
> spirochete).  It is true that it can produce many different
> symptoms, but it is not at all in the same category with CFS,
> for which no cause has yet been identified.  Lyme is in the
> differential diagnosis of patient presenting with fatigue.  So
> are other diseases, such as mono and MS.

	I don't understand your point here. All he said was that the
symptoms of Lyme and of CFS are similar. This is a fact. But CFS is
(by definition) a syndrome, not a specific illness. There are no doubt
many causes of CFS; it's not a single entity. It's a garbage heap
diagnosis.


> >(some researchers speculate that much of MS is undiagnosed Lyme, and
> >that all of CFIDS is).
> >
> I've never seen any legitimate researcher speculate that much of MS
> is undiagnosed Lyme.  Only quacks who do no research, but only
> charge huge sums to patients with MS for giving them worthless
> lyme treatments.  Do you have anyone in particular in mind, or
> did you just toss this one out?

	The first half of this century saw literally dozens of papers
(mostly European, especially German) linking "MS" to a spirochetal agent.
These folks were staining spirochetes all over the place. They may have
in fact been dealing with Lyme disease, but it certainly is clear that
plenty of Lyme patients have symptoms that are clinically indistinguishable
from MS. It's very easy to confuse the two. That these researchers were
recovering spirochetes from the tissues of these "MS" patients only
underscores this fact.
	Halperin had an '89 paper in Neurology - sorry, I don't have
the reference in front of me, but it had a broad title, something like
"Lyme neuroborreliosis" - in which he touched on the purported
relationship bewteen Lyme and MS. He had several "MS" patients who
had positive serologies for Lyme, but concluded they'd had only coincidental
exposure to B. burgdorferi. Yeah, right. I forget his rationale, but I
remember that I wasn't impressed. He had some really weak ones, like
the MRIs of the MS patients had "larger" areas of hyperintensity, and they
were sicker longer than the Lyme patients (this one made no sense to
me at all). He also pointed out that these patients had no intrathecal
antibody synthesis to Bb, which has been a completely discredited "marker"
for CNS invasion by the spirochete, but which Halperin seems reluctant
to abandon. (Although his abstract for the last Lyme conference leads me
to believe he may be coming to his senses.) The one good point he had
was that these patients had abnormal VERs; this may be a good way to
differentiate the two, although if you think about it, it's completely
circular reasoning: you arbitrarily define all the patients with abnormal
VERs and positive Lyme serologies as having MS.
	Look, let's not get carried away with this: Lyme and MS are
almost certainly distinct clinical entities, but there is absolutely no
doubt whatsoever that more than few Lyme patients have been misdiagnosed
(by lousy doctors, obviously) as having MS. It seems reasonable to
speculate a little on the possible "connection" at least with regard to
bad diagnoses between the two. Willy Burgdorfer himself has expressed
this philosophy, as have clinicians like Ken Liegner and Paul Lavoie.
	Other things to keep in mind: ever think about the geographic
distribution of MS? It coincides exactly with the emerging demographics
on Lyme. MS is much more common in animal husbandry areas, and among people
who work with animals in general. There's a NEJM article from the 70's
that links MS with the dairy industry. Don't you think this is provocative?
	Also, Gordon, please stop calling all physicians who treat
seronegative patients "quacks." This is unfair. I know many of these guys,
and they are anything but. They're just tired of withholding treatment
and seeing their patients suffer irreversible neurological damage because
they (the doctors) clung too closely to what "the book" on Lyme says.
After a few dozen of your patients end up in wheelchairs, you tend to
modify your attitude. Seronegativity is real; there is nothing scientific
about pretending it isn't. Withholding treatment for seronegative patients
with symptoms highly suggestive of Lyme: *That's* quackery. I promise
you: if you worked in an endemic area, you would modify your views on
this. Any good doctor would. 


> ----------------------------------------------------------------------------
> Gordon Banks  N3JXP      | "Skepticism is the chastity of the intellect, and
> geb@cadre.dsl.pitt.edu   |  it is shameful to surrender it too soon." 
> ----------------------------------------------------------------------------

Carl Brenner