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Question:

On a SPECT Scan I recently had it showed moderately, severe global, cortical hypoperfusion with heterogeneity.

The pattern is consistent with encephalitis or vasculitis such as an infection eg. Lyme disease. I have been on Augmentin 1500mgs. a day since September.

What does this mean? Should antibiotic be changed?

Answered by: Brian Fallon

Specific medical advice for an individual patient cannot be given without an in-person evaluation. So, what I say may or may not be appropriate for your case.

The simplest answer to your question is that there are still too many unknowns about how to use brain SPECT scans. I have the clinical impression that it can take a very long time for the brain SPECT scan to improve (perhaps many months to years)...lagging far behind the clinical improvement a patient may experience.

This is unfortunate because patients then get quite frightened when they read "moderately severe global hypoperfusion".

My advice to you is to discuss your care with your doctor based on your clinical symptoms and to avoid being guided by the brain SPECT results until science has a better grasp of how to use the SPECT scans.

It's also worth noting that symptoms may persist even in the absence of persistent infection. We are currently analyzing the results of a brain SPECT scan study which should shed light on these questions.



Brian Fallon, M.D., M.P.H., M.Ed.

Director, Lyme and Tick-Borne Diseases Research Center

Brian A. Fallon, MD, MPH, is the director of the Center for Neuroinflammatory Disorders and Biobehavioral Medicine and director of the Lyme and Tick-Borne Diseases Research Center at Columbia University.

A graduate of Harvard College, he obtained his M.D. degree from the Columbia University College of Physicians and Surgeons, as well as a master's degree in public health epidemiology from Columbia University.

He did his medical internship at Columbia University Medical Center and research training and an NIH fellowship in biological psychiatry at Columbia Presbyterian Medical ...
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