Dr. Joseph Burrascano warned 30 years ago about the dangers of using steroids to treat the symptoms of Lyme disease. So it was hard not to laugh out loud when I came across this most recent Harvard Lyme research.Four researchers from Massachusetts Eye and Ear/Harvard Medical School have found that patients who were prescribed corticosteroids as part of treatment for Lyme disease-associated facial paralysis had worse long-term outcomes of regaining facial function than those who were prescribed antibiotic therapy alone. Based on these findings, which were published online in Laryngoscope, the researchers urge caution in prescribing corticosteroids to patients with acute Lyme disease-associated facial paralysis.
The lead author of the published report is Nate Jowett, M.D., FRCSC, a facial plastic and reconstructive surgeon at Massachusetts Eye and Ear and an Instructor in Otolaryngology at Harvard Medical School. He told reporters, “While further study is needed to determine the effect of corticosteroids in the setting of acute Lyme disease-associated facial paralysis, this retrospective study demonstrated a clear association between their use and worse long-term facial outcomes.”
He continued, “Since corticosteroids are part of the standard of care for acute viral facial paralysis, it is not surprising that they were initially prescribed to roughly two-thirds of the patients with Lyme disease-associated facial paralysis in this study. Our findings underline the importance of differentiating patients with facial weakness due to Lyme disease — for whom the standard of care is prompt antibiotic therapy — from those with acute viral facial paralysis, such as Bell’s palsy or varicella-zoster virus — for whom the standard of care includes early treatment with corticosteroids and antivirals.”
Perhaps we can hope that not every Harvard doctor has drunk the IDSA Lyme Kool-Aid. I continue to believe that the pressure will continue to build on the scientific bottle-neck created by Harvard’s intractable stance regarding chronic Lyme disease due to the exemplary work being done by John Hopkins, Stanford and Boston University (to name just a few).
As many readers have shared via anecdotal stories, the diagnosis and treatment options for people with chronic Lyme disease 15 years ago was much more limited than it is today. Of course we are all holding our breath for a real cure.