Review Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?, 2024, Adler

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REVIEW article
Front. Neurol., 08 February 2024
Sec. Autonomic Disorders
Volume 15 - 2024 | https://doi.org/10.3389/fneur.2024.1344862

Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?
Brittany L. Adler1*Tae Chung2Peter C. Rowe3John Aucott1

• 1Division of Rheumatology, Johns Hopkins University, Baltimore, MD, United States
• 2Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
• 3Department of Pediatrics, Johns Hopkins University, Baltimore, MD, United States

Dysautonomia, or dysfunction of the autonomic nervous system (ANS), may occur following an infectious insult and can result in a variety of debilitating, widespread, and often poorly recognized symptoms.

Dysautonomia is now widely accepted as a complication of COVID-19 and is an important component of Post-Acute Sequelae of COVID-19 (PASC or long COVID).

PASC shares many overlapping clinical features with other infection-associated chronic illnesses including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Treatment Lyme Disease Syndrome (PTLDS), suggesting that they may share common underlying mechanisms including autonomic dysfunction.

Despite the recognition of this complication of Lyme disease in the care of patients with PTLD, there has been a scarcity of research in this field and dysautonomia has not yet been established as a complication of Lyme disease in the medical literature.

In this review, we discuss the evidence implicating Borrelia burgdorferi as a cause of dysautonomia and the related symptoms, propose potential pathogenic mechanisms given our knowledge of Lyme disease and mechanisms of PASC and ME/CFS, and discuss the diagnostic evaluation and treatments of dysautonomia.

We also outline gaps in the literature and priorities for future research.

 

Seems likely to me. Lyme is a shocker of an infection and very difficult to treat if it’s not blitzed early enough. Also any enduring and or permanently damaging infection or injury, could well happen to hit the autonomic nervous system with such unfortunate consequences.