I am not sure anyone here can say for sure. Weren't you told about that a while back? If so, is it getting worse now or something?

Are you having more fevers, or chills? Any other symptoms? Lettuce know!

Be sure to check the deep tendon reflex comment AND the spinal tap info below that. Take care of you.

"Patients may have involvement of the optic nerve with an optic neuritis or a papillitis, resultant vision loss.

Peripheral neuropathy with distal parasthesias, subtle weakness, diminished deep tendon reflexes have also been seen.

The laboratory work-up is rather unrevealing. CBC's are almost always normal. Sed Rates of greater than 30 have occurred in only ten percent of the patients and we have had only two patients who have Sed Rates of 100 or more. EEG's have been abnormal in one-third of the patients showing bilateral sharp waves and some slowing. The CAT Scans have been normal but a number of MRI's have been abnormal showing evidence of increased signal in the white matter.

The decision to do a spinal tap on a patient with Lyme Disease is based on the physical findings. Obviously, if a patient has papilledema, they will be tapped after a CAT Scan or MRI shows no mass lesion. But in other cases, the decision to do the tap is based primarily on the need for additional diagnostic information or where there is a question as to whether the diagnosis is something other than Lyme. We have tapped about twenty-five [sic] patients so far. The majority have had normal spinal fluid findings. Usually, they have no elevation of their white cells. Protein and sugars are normal. Cultures are negative. Interestingly, however, at least fifty percent of them show increased pressure with opening pressures greater than 200, sometimes as high as 400. Every patient with papilledema has had a pressure of at least 300 or more except for one girl whose opening pressure was 260 but she had obvious papilledema and also loss of vision in her left eye. Eight of the patients had a pleocytosis with cells ranging from 60 to 700, predominantly lymphocytes. Only two patients showed a positive CSF titer.

The diagnosis of Lyme Disease is a clinical one. The serology, if positive, is helpful. We consider a positive serology as a 1:128 IFA; ELISA that is greater than .79. Urine antigens can also be measured."

Here are two quips about the deep tendon reflexes. The first you can wade through or go to the second, an "easier on the brain this late at night" explanation. It can be done by a physical therapist trained to do it, or a medical doc. It is not complicated and a Neurologist is not needed, although it is usually considered a neurological test, which it is, to determine basic functioning.

If I remember right, a Babenski Sign, is a neuro test/result. I believe it is the one done by having a hard object quickly run up the bottom of your foot. If your toes curl downward, that is normal. If they curl upwards, it is a positive Babenski sign (often seen in Lyme patients with neuro problems). I will check that...I may have it backwards. I have a positive Babenski...but I can't do that to my own foot without laughing! It tickles!

THE COMPLICATED EXPLANATION:
Deep tendon reflexes test an arc of sensory input that travels through the spinal cord and
results in muscle contraction. Each reflex corresponds to a certain level of the cord, for
example the "ankle Jerk" is testing the first sacral nerve root. Reflexes are graded on a
scale 0-4, with 0 being absent, 1 being underactive, 2 and 3 being average, and 4 being
clearly heyperactive. 1+ and +1 have the same meaning. In general, reflexes are not
pathological if symmetric unless they are absent or hyperreflexic. Assymetry of reflexes
and absent reflexes tend to localize to a peripheral nervous system process. Increased
reflexes tend to indicate a problem of the central nervous sytem. Reflexes are routinely
tested on neuro exam and are nonspecific as to the etiology of the disease process if
abnormal. They provide information to help localize the problem. Very seldom is one or
more abnormal reflexes the only abnormality. More often, abnormal reflexes corroborate
other symptoms and sign. Small and large fiber refer to the diameter of specific sensory
nerves. Larger fibers are responsible for vibratory sensation and joint position. Small
fibers are responsible for conveying pain and temperature sensation. In small fiber
neuropathies, tendon reflexes may be retained.

OR THE SIMPLER VERSION:
Knee jerk: The reflex tested by tapping just below the knee causing the lower leg to
suddenly jerk forward.
What is tapped to elicit this reaction is the patellar , the tendon that runs down from the
muscle in the front of the thigh, over the kneecap (the ), down to the lower leg. And what
happens is that the quadriceps contracts and abruptly brings the lower leg forward. This
reaction is involuntary since it occurs without the person willing it to happen.
The knee jerk is best tested by giving a smart tap on the patellar tendon while the lower
leg hangs loosely at a right angle with the . The test is part of the clinical neurologic
examination. The knee jerk is a deep tendon reflex (DTR). (The ankle (Achilles tendon)
jerk is another.) DTRs can be graded:
zero absent
1+ hypoactive (underactive)
2+ "normal"
3+ hyperactive (overactive) without clonus (extra jerks)
4+ hyperactive with unsustained clonus (just 1 or 2 extra jerks)
5+ hyperactive with sustained clonus (continued jerking)
The normal knee-jerk reflex may range from hypoactive (1+) to brisk (3+).
An asymmetric reflex in which one knee jerk on one side is different than that on the
other side is abnormal. So is the spread of tendon reflexes (tapping one knee and
observing contraction of muscles elsewhere). And sustained clonus is also distictly
abnormal. Absence of the knee jerk can be due to an abnormality in the "reflex arc"
required for the reflex to occur (the muscle "spindles" or the nerve fibers going from the
patellar tendon to the spinal cord and returning from the spinal cord to the quadriceps).
With a stroke, the knee-jerk reflex may at first be underactive, then recover and become
hyperactive within a day or two.
The knee jerk has been so often tested and become so familiar that it has given rise to the
adjective "knee-jerk" as in a knee-jerk reaction. Knee-jerk in this figurative sense means
"readily predictable to the point of being automatic." It often has a negative connotation
and conveys the idea of an all-too-hasty, impulsive, irrational response based on a preset
idea. For example, a dictator's knee-jerk response to a democratic movement is to
suppress it.
The knee-jerk reflex is also medically called the patellar reflex. It is less often referred to
as the knee phenomenon, the knee reflex, the patellar tendon reflex, the quadriceps
reflex, or the patellar tendon reflex.

Definition

Reflex tests are simple physical tests of nervous system function.

Purpose

A reflex is a simple nerve circuit. A stimulus, such as a light tap with a rubber hammer, causes sensory neurons (nerve cells) to send signals to the spinal cord. Here, the signals are conveyed both to the brain and to nerves that control muscles affected by the stimulus. Without any brain intervention, these muscles may respond to an appropriate stimulus by contracting.

Reflex tests measure the presence and strength of a number of reflexes. In so doing, they help to assess the integrity of the nerve circuits involved. Reflex tests are performed as part of a neurological exam, either a "mini-exam" done to quickly confirm integrity of the spinal cord, or a more complete exam performed to diagnose the presence and location of spinal cord injury or neuromuscular disease.

Deep tendon reflexes are responses to muscle stretch. The familiar "knee-jerk" reflex is an example; this reflex tests the integrity of the spinal cord in the lower back region. The usual set of deep tendon reflexes tested, involving increasingly higher regions of the spinal cord, are:

* Ankle

* Knee

* Abdomen

* Forearm

* Biceps

* Triceps

Another type of reflex test is called the Babinski test, which involves gently stroking the sole of the foot to assess proper development of the spine and cerebral cortex.

Precautions

Reflex tests are entirely safe, and no special precautions are needed.

Description

The examiner positions the patient in a comfortable position, usually seated on the examination table with legs hanging free. The examiner uses a rubber mallet to strike different points on the patient's body, and observes the response. The examiner may position, or hold, one of the limbs during testing, and may require exposure of the ankles, knees, abdomen, and arms. Reflexes can be difficult to elicit if the patient is paying too much attention to the stimulus. To compensate for this, the patient may be asked to perform some muscle contraction, such as clenching teeth or grasping and pulling the two hands apart. When performing the Babinski reflex test, the doctor will gently stroke the outer soles of the patient's feet with the mallet while checking to see whether or not the big toe extends out as a result.

Normal results

The strength of the response depends partly on the strength of the stimulus. For this reason, the examiner will attempt to elicit the response with the smallest stimulus possible. Learning the range of normal responses requires some clinical training. Responses should be the same for both sides of the body. A normal response to the Babinski reflex test depends upon the age of the person being examined. In children under the age of one and a half years, the big toe will extend out with or without the other toes. This is due to the fact that the fibers in the spinal cord and cerebral cortex have not been completely covered in myelin, the protein and lipid sheath that aids in processing neural signals. In adults and children over the age of one and a half years, the myelin sheath should be completely formed, and, as a result, all the toes will curl under (planter flexion reflex).

Abnormal results

I am sorry you are doing worse. I know you are scared. You have a right to be. Shall I call the doc? I will be happy to contact them if you would like. I am not sure what else to tell you at this point, or what else I can do to relieve your fear. You must reach your doc and tell him the fear you are experiencing, or make the other one listen. Or go to the Emergency room. You need to get help. My choice would be to reach your doc asap. Let me know and I will contact him if you want me to.

Gisell, hope to hear you're better tomorrow. There are some scary times with this stuff.

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Originally posted by rosespetal:
Hi, sorry to hear you're feelling so badly.
I have somewhat of the same problem, except I feel as if I had been to the gym all day yesterday. My arms cannot handle more than 5lbs for 3 minutes without becoming so painful and weak. My neck is getting waves of pain as well. Went to a Dr who said I have chronic hives, and I also get waves of face flushing. My ANA was negative, my sed rate ranges from 4 to 11, all good. They are unsure what's going on with me as well, tests up the wazooo,and now are unsure of exactly what I am allergic to as well from the hives, and am off for a bone scan today to check for inflammation as my lower back and head to my shoulders kill sometimes so painful I can't walk, figures it's not 'flaring' much today!! PLMK what comes of your tests. My Rheumatologist thought it was a slight possibility of Lupus, and leaned more towards Chronic Lyme, my dr's at the university in Newark, (immunology/allergy) don't believe in lyme past 3 weeks of abx. Good luck to you!! Hope you start feeling better, or atleast they figure it out so you can get proper treatment!!
-Michelle

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