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Parkinson's Disease

Lyme disease or meningitis -Can this onset PD

11/13/2006

Question:

My stepfather thought he was bitten by a spider and visited his doctor. The doctor stated he had lyme disease and was released. Over the next week, his LOC was extremely diminished. At the ER, he was diagnosed with meningitis instead. After that incident, he rapidly declined and within one year was diagnosed with PD. Could this have triggered the condition? Also, exactly where is the substantia niagria located? Is it near the lateral horns?

Answer:

There are multiple, long-term effects that are possible after a bout of meningitis/encephalitis.  Post infectious parkinsonism is most remembered being associated with a world-wide outbreak of an illness causing encephalitis in the early part of the 20th century.  It rarely has been associated with similar infectious causes since. 

The encephalitides most reported associated with parkinsonism include Japanese encephalitis and Western equine encephalitis.  Symptoms in these cases were usually transient.  Other types have been occasionally suspected, but association is questionable.  It has rarely been associated also with non-viral illnesses such as syphilis. 

Lyme disease can cause numerous multi-system problems, but parkinsonism has not been specifically associated with it.  However, in a significant case of encephalitis, it would not be unreasonable to consider the vulnerability of numerous areas of the brain.  It may be that an illness this significant might also unmask pre-existing parkinson's disease.  It is very difficult to make the association, but might be considered, especially if the parkinsonism is atypical in its presentation.  

The subtantia nigra is located in the mid-brain portion of the brain stem.

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Response by:

Karen M Thomas, DO Karen M Thomas, DO
Formerly:
College of Medicine
The Ohio State University