“Stage 3 Lyme or M.S.?”
7 years ago I had an engorged deer tick and developed a bulls eye rash. The blood test at that time was negative, so it went untreated. Recently I was hospitalized with symptoms and testing (spinal tap) that suggest possible Multiple Sclerosis. It is my understanding that Lyme Disease has been again ruled out. Is an engorged deer tick followed by a bulls eye rash ALWAYS indicative of Lyme Disease?
Female | 46 years old
Complaint duration: months
Conditions: joint pain, fatigue, vision problems
3 Answers
NeurologistLymeDisease
Hello, The rash often associated with early Lyme disease can be associated with other conditions, including tick bite hypersensitivity reaction, southern tickassociated rash illness STARI, nummular eczema, granuloma annulare, and tinea corporis. So it's possible your rash was not due to Lyme disease. Also Lyme disease testing is not that great, which is why repeat testing is often recommended if Lyme disease is suspected. If you had a spinal tap, then the testing for Multiple Sclerosis is different than the Lyme disease testing performed on the spinal fluid. Also I will assume you had an MRI of the brain and spinal cord if you may have Multiple Sclerosis. Again the MRI imaging results will be a bit different for those conditions. Understand that no test is perfect. Your symptoms are consistent with Multiple Sclerosis other than the joint pain, which is a bit atypical and could actually be indicative of Lyme disease as well as some other conditions such as neurosarcoidosis. If your vision problems were intermittent episodes of double vision, that is classic for Multiple Sclerosis.
Based on your history tick EM rash, you very likely had Lyme disease. If it was untreated, neurologic sequelae are possible even years later, though this is rare. You deserve a second opinion, ideally with both A Lymeliterate infectious disease doctor A neurologist familiar with LymeMS overlap.
It is highly suspicious for Lyme disease, but not pathognomonic.
