What are the year 2013 boundaries of Lyme borreliosis ;; What are the "4 corners" which a surveyor would implant into the soil to mark the domain of Lyme borreliosis?
I am so glad that you asked how ,and why, and when did all this "New Stuff" ever happen??
After all ,.....the original definitions of Dr. Allen Steere have persisted over 30 years and retain the
utility for the Ingenue..
These describe a disease which is" hard to catch and easy to treat"
What are the year 2013 boundaries of Lyme borreliosis ;; What are the "4 corners" which a surveyor would
implant into the soil to mark the domain of Lyme borreliosis?
In the 1980's there was a reconciliation of the Pre-spirochetal domains of Lyme as described by Dr Allen Steere
with a newly discovered spirochetal infectious agent, undreamed of by Steere, who was convinced that
a virus was the cause.
Steere's Lyme Universe included what I call the Four cardinal points of the "lyme Compass"
Joint [ mainly knee]
Cardiac conduction system [ Atrioventricular node , His bundle and distal cardiac conduction system]
Meninges - Meningitis- of the lining tissues of the surface of the brain.
To the Lyme Compass we add:
Paralysis of the Facial nerve [Cranial Nerve v11]
As the territory where Lyme disease was originally diagnosed, [ New Haven and Lyme ,Conn]
yielded to an ever increasing geographic perimeter, and as the Enormous Contributions of
European Physicians were slowly integrated into Dr Steere's Lyme universe,
"new" manifestations of Lyme Borreliosis were added to the Geography of Dr. Steere's Disease.
He has not been pleased by some of the "newer" manifestations of Lyme borreliosis.
In 30 years since the discovery of Borrelia burgdorferi, many other Borrelia strains in the USA and in Europe
and around the world have been recognized, with Each strain capable of producing disease manifestations
which Dr Steere in 1982 could never have predicted would be certifiable illnesses caused by the
Borrelia burgdorferi family [sensu latu] of tick borne spirochetes.
European Lyme borreliosis has many manifestations of disease which are not
identified in New Haven Conn or in Boston Massachusetts...........
Acrodermatitis chronica atrophicans, borrelia lymphocytoma, Malignant Lymphomas of the MALT type and of
the Mycosis Fungoides type, Dilated Cardiomyopathy, Cerebral Vasculitis with Strokes, Romberg Parry Syndrome,
Temporal Arteritis [Giant cell arteritis], Spinal Cord diseases [transverse myelitis with or without syrinx formation],
and an ever expanding number of skin disorders as defined by Drs Klaus Eisendle and Professor Dr Bernhard Zelger.
Since year 1987, Lyme disease has been implicated in diseases of the Eye, and the ophthalmological spectrum
of inflammatory and degenerative diseases of the Eye from the cornea to the Optic nerve have burgeoned.
Every Cranial nerve has the possibility of being diseased by Lyme borreliosis, so we have long ago
passed Isolated Facial nerve Palsy [Bell's palsy} in the Right hand lane of the Autobahn of Lyme borreliosis
discovery. Lyme borreliosis is now known to cause the Argyll Robertson pupil abnormality; The AR pupil having been
a sentinel sign of Syphilis infection in the Last century.
Lyme induced Horner's disease has been verified.
Lyme induced urinary Bladder dysfunction has been verified.
Lyme disease exactly mimicking Spinal disk degeneration symptoms has been verified.
Lyme disease Dementia has been on the map since 1986.
Lyme disease Motor Neuron Disease has been described in several threads on this forum.
Lyme disease fatalities verified by autopsy are now in the peer reviewed literature, including the first
report by Dr Allen Steere and Dr Peter Schlesinger in 1985 of Trans-placental transmission of the Lyme
disease spirochete from a pregnant woman to her fetus , with neonatal death and associated Congenital
Heart Malformations. The American Lyme Disease Foundation website informs us that Fatalities do not
occur in Lyme borreliosis. An ever increasing register of Lyme focused Autopsies has overturned this
So, As we survey the perimeters of Lyme Borreliosis, we learn that many new investigators are discovering
manifestations of Lyme borreliosis which were never dreamed of in Dr. Allen Steere's original series of cases.
Some of the Non- Steere described newer manifestations of Lyme Borreliosis are disputed by Dr. Steere
as "Not Lyme". He certainly is free to express his opinions and he is free to write his objections to the
progresses in clinical identifications of Lyme Borreliosis in the year 2013 and beyond.
Simply stated ---
There are more linkages between the model of human syphilis in its protean manifestations and Lyme Borreliosis
with its protean manifestations than can be concisely summarized in a paragraph.
If you want to "catch up" you can begin in 1975 and read the 9000 articles which have been peer reviewed to date.
So exercise caution when you reject out of hand a "non-Steere-ian" Lyme borreliosis disease condition.
To act in a peremptory rejection mode ...
is to walk on thin ice...
and to reserve an opportunity to dine on a meal of Crow....
Alan B. MacDonald, MD
Joined: Fri 13 Jan 2012 22:32