Lyme disease other imaging findings

	Lyme disease Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Epidemiology and Demographics
Causes
Differentiating Lyme disease from other Diseases
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
ECG
X-ray
CT scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Sudies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Lyme disease other imaging findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Lyme disease other imaging findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Lyme disease other imaging findings
CDC on Lyme disease other imaging findings
Lyme disease other imaging findings in the news
Blogs on Lyme disease other imaging findings
Directions to Hospitals Treating Lyme disease
Risk calculators and risk factors for Lyme disease other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Single photon emission computed tomography is one of the major other imaging modalities of Lyme disease. In Lyme patients, cerebral hypoperfusion of frontal subcortical and cortical structures has been found.

Single photon emission computed tomography (SPECT) imaging has been used to look for cerebral hypoperfusion which indicates Lyme encephalitis in the patient.^[1]

In Lyme patients, cerebral hypoperfusion of frontal subcortical and cortical structures has been found.^[2]
In about 70% of late stage Lyme disease patients with cognitive symptoms, brain SPECT scans typically show a pattern of global hypoperfusion in a heterogeneous distribution through the white matter.^[3]
This is a non specific pattern for Lyme disease, as similar pattern can be observed in other central nervous system (CNS) syndromes such as HIV encephalopathy, viral encephalopathy, chronic cocaine use, and vasculitides.
Careful history taking of the patient and serologic testing can easily rule out most of these syndromes.

Global cerebral hypoperfusion deficits on SPECT in the presence of characteristic neuropsychiatric features of Lyme disease should raise suspicion of Lyme encephalopathy among patients who inhabit or have traveled to endemic areas, regardless of patient recall of a tick bite.
Late stage Lyme disease can occur many years after initial infection.
The average time from symptom onset to diagnosis in these patients is about 4 years.
Seronegative disease can occur, and because CSF testing is often normal, Lyme encephalopathy often becomes a diagnosis of exclusion.
Aberrant SPECT patterns are caused by cerebral vasculitis. Brain biopsy is not commonly performed for these cases, as opposed to other types of cerebral vasculitis.

↑ Sumiya H, Kobayashi K, Mizukoshi C; et al. (1997). "Brain perfusion SPECT in Lyme neuroborreliosis". J. Nucl. Med. 38 (7): 1120–2. PMID 9225802.
↑ Logigian EL, Johnson KA, Kijewski MF; et al. (1997). "Reversible cerebral hypoperfusion in Lyme encephalopathy". Neurology. 49 (6): 1661–70. PMID 9409364.
↑ Fallon BA, Das S, Plutchok JJ, Tager F, Liegner K, Van Heertum R (1997). "Functional brain imaging and neuropsychological testing in Lyme disease". Clin. Infect. Dis. 25 Suppl 1: S57–63. PMID 9233666.