Looking at Lyme20 Sep 2022

48. Looking at the brain with Eboni Cornish

Dr. Cornish is an integrative functional physician working at the Amen Clinics. She was introduced to chronic Lyme disease when working with a patient who was not cured by a short course of antibiotics. The patient, a landscaper who presented with a bullseye rash followed by ongoing Lyme symptoms, had been labeled as a “drug seeking” patient. This caused Dr. Cornish to ask the question, “Who in the world drug-seeks antibiotics?” After joining a medical practice in a Lyme endemic area, Dr. Cornish learned about the International Lyme and Associated Diseases Society (ILADS), and eventually became a Board member.

While CT and MRI scans of the brain examine the function and anatomy, Dr. Cornish explains that a SPECT scan, a single photon emission computerized tomography scan, looks at brain activity and blood flow. She explains that areas of the brain that have less blood flow or activity appear almost like “holes” on a SPECT scan. These changes can be caused by toxins, head injury, Alzheimer’s, Lyme disease and other infections.

Although SPECT scans alone are not diagnostic of Lyme disease, scans can be used to figure out what questions to ask. Dr. Cornish looks for areas of inflammation and “scattered early activity”. Later in the disease process, the activity may be less scattered and may take on a scalloped appearance with decreased blood flow, indicating brain inflammation. The scan, along with a physical exam and detailed patient history help a physician determine differential diagnoses. Dr. Cornish notes that brain inflammation can be caused by a number of toxins such as mold, Lyme, and other tick-borne infections.

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