Dull pain in the upper jawbone under the right edge of the right eye occurs regularly twice a week, followed by intense ringing in the ears and visual disturbances radiating towards the jaw. Then, within 1-2 days, the symptoms almost disappear, and so on. There are two types of Lyme and Bartonella, although the latter shows a nice downward trend in serological tests (vibrant) due to the effect of the medication. So my question is, because the FOG and dental CT scans naturally show nothing, the diagnosis is chronic sinusitis, which is obviously caused by either Lyme or Bartonella. What can be done? Is there a targeted treatment? In my opinion, there may be some hidden focus that could be burdening the immune system. Thank you!
The symptoms described (pain in the upper jaw below the eye, tinnitus, visual disturbances, pain radiating to the jaw) are indeed unpleasant, but it is worth clarifying a few important misunderstandings.
- The cause of chronic sinusitis is not necessarily Lyme or Bartonella infection.
The most common causes of chronic sinusitis are persistent mucosal inflammation, allergies, bacterial or fungal infections, anatomical abnormalities (such as a deviated septum) or dental problems. If a dental CT scan shows no abnormalities, this significantly reduces the likelihood of a dental source, and the diagnosis of sinusitis may require further confirmation. - Changes in serological tests do not always reflect the activity of the infection. In the case of Lyme disease and other tick-borne infections, IgG antibodies may be detectable for a long time, so changes in laboratory values must always be evaluated in conjunction with clinical symptoms. An increase or decrease in antibody levels alone does not prove the activity of the infection. In fact, in the case of cured Lyme disease, the ideal result would be a long-lasting, multi-antigen-reactive IgG that slowly decreases – this is also referred to as the “serological scar” healing. It is recommended to perform a direct diagnostic test (e.g. Dualdur), which can detect the presence of the pathogen.
- The assumption of a “hidden focus” is common, but unlikely in the absence of imaging abnormalities.
Symptoms that occur periodically and then disappear within a few days may indicate a neurological or functional problem, such as:
- irritation of the trigeminal nerve,
- temporomandibular (jaw joint) problems,
- certain forms of migraine,
- or functional disorders of the ear, nose and throat.
- The possibility of Lyme disease or co-infections
The cranial nerves are the usual targets of Borrelia bacteria.
The literature reports some cases in which the neurological form of Lyme disease (Lyme neuroborreliosis) may affect the trigeminal nerve, which is responsible for sensory innervation of the face. One case study, for example, described trigeminal neuralgia resulting from Lyme infection, which manifested as unilateral facial pain and pain radiating to the jaw and eye area.
In another report, nerve damage caused by Lyme infection resulted in toothache-like pain radiating to the jaw and temple, while dental examinations found no abnormalities.
One specific characteristic of Borrelia infection is fluctuating symptoms, but the recurrence of symptoms tends to be every two weeks or less. If there is a regular interval of at least one week between symptomatic periods, Lyme disease is more likely to be the cause.
- Treatment for Lyme infection involves more than just antibiotics.
The treatment of Lyme disease is a complex process. According to some therapeutic regimens, several weeks of pre-treatment and organisational preparation (e.g. complementary therapy) are recommended before treatment in order to reduce side effects and improve the effectiveness of treatment. This preparation can begin up to 3-4 weeks before the actual antibiotic treatment and can continue during therapy.
In such cases, treatment is usually carried out under regular medical and laboratory supervision, as prolonged combined treatment requires monitoring.
- What can be done in practice?
If imaging tests have not confirmed a clear sinus or dental problem, it is worth continuing the investigation in other directions:
- ear, nose and throat check-up
- neurological examination (trigeminal nerve, possibility of migraine)
- temporomandibular joint examination
- MRI scan if necessary
- Direct detection of Borrelia, alternative tests
In summary:
Although the symptoms described may be characteristic of Lyme or Bartonella infection, their periodicity is too frequent for this. With a negative CT scan, chronic sinusitis is also not clear. Treatment is always based on an accurate diagnosis, and even in the case of Lyme infection, a properly structured treatment plan supervised by a physician knowledgeable about Lyme disease is important.
Sources:
(C) Lyme Borreliosis Foundation
