SPECT scanning of the brain- Unlike MRI and CT scans, which show structure, SPECT scans show function.
Therefore SPECT scans give us information unattainable through X-rays, CT scans, MRI’s, or even spinal taps.
In the majority of chronic Lyme Borreliosis patients, these scans are abnormal. Although not diagnostic of
Lyme specifically, if the scan is abnormal, the scan can not only quantify the abnormalities, but the pattern can
help to differentiate medical from psychiatric causes of these changes. Furthermore, repeat scans after a
course of treatment can be used to assess treatment efficacy. Note that improvement in scans lag behind
clinical improvement by many months.
If done by knowledgeable radiologists using high-resolution equipment, scanning will show characteristic abnormalities in Lyme encephalopathy- global hypoperfusion (may be homogenous or heterogeneous). What these scans demonstrate is neuronal dysfunction and/or varying degrees of cerebrolvascular insufficiency. If necessary, to assess the relative contributions of these two processes, the SPECT scan can be done before and after acetazolamide. If the post acetazolamide scan shows significant reversibility of the abnormalities, then vasoconstriction is present, and can be treated with vasodilators, which may clear some cognitive symptoms. Therapy can include acetazolamide, serotonin agonists and even Ginkgo biloba, provided it is of pharmaceutical quality. Therapeutic trials of these may be needed.
Acetazolamide should not be given if there is severe kidney/liver disease, electrolyte abnormalities, pregnancy, sulfa allergy, recent stroke, or if the patient is taking high dose aspirin treatment
If done by knowledgeable radiologists using high-resolution equipment, scanning will show characteristic abnormalities in Lyme encephalopathy- global hypoperfusion (may be homogenous or heterogeneous). What these scans demonstrate is neuronal dysfunction and/or varying degrees of cerebrolvascular insufficiency. If necessary, to assess the relative contributions of these two processes, the SPECT scan can be done before and after acetazolamide. If the post acetazolamide scan shows significant reversibility of the abnormalities, then vasoconstriction is present, and can be treated with vasodilators, which may clear some cognitive symptoms. Therapy can include acetazolamide, serotonin agonists and even Ginkgo biloba, provided it is of pharmaceutical quality. Therapeutic trials of these may be needed.
Acetazolamide should not be given if there is severe kidney/liver disease, electrolyte abnormalities, pregnancy, sulfa allergy, recent stroke, or if the patient is taking high dose aspirin treatment
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