I am pleased to announce the following: Since April 1999, 150 ALS patients have been tested for Lyme disease with a panoply of tests - incl Western Blot, LUAT, PCR.  Not one patient has been found to be negative across all tests.  Many have been shown to be PCR positive. The prognosis and disease development of these patients is entirely consistent with ALS. Treatment with oral antibiotic therapy has shown mixed results.  In particular the use of conventional antibiotics (esp. doxycycline) has been associated with deterioration of ALS patients.  In one case the patient rapidly succumbed.  In earlier stage ALS patients there is some evidence for improvement, with restoration of speech in two patients and some reported easier swallowing, when treated with oral metronidazole or tinidazole. The reactivity of ALS patients to Lyme tests has been previously reported . In the course of the past 9 weeks a patient (body weight 125lbs, 66 years of age) with advanced ALS symptoms has been treated aggressively with IV metronidazole + conventional antibiotics (Biaxin initially) at doses of 500mg tid metronidazole IV and 500mg Biaxin bid orally.  The diagnosis of ALS was made at the Mayo clinic.  The patient was admitted in respiratory failure with tongue fasciculations, weakness in the right arm.  The immediate prognosis was poor and the attending physician expected the patient to expire within 24 hours.  The patient was ventilated.  In the course of 7 weeks of the above therapy the patient has improved and is now ambulatory and off of ventilation using only occasional nasal oxygen.  On the IV therapy the tongue fasciculations disappeared. After 7 weeks the patient was taken off of the IV meds and treated with only oral tetracycline (500mg qid).  On this treatment the tongue fasciculations returned.  The IV therapy was reinstated with IV Rocephin replacing the oral Biaxin and the tongue fasciculations ceased.  The patient continues to improve on a daily basis. Tentative conclusions: The etiologic agent of ALS is Borrelia burgdorferi. Effective treatment of late stage ALS is possible with aggressive antibiotic therapy that must include metronidazole.  Other researchers have recently reported success in treating early stage ALS with antibiotic therapy. ALS patients should not be treated with simple "textbook" antibiotic therapy which does not include a nitroimidazole. This therapy should be considered experimental at this stage. Regards Martin Atkinson-Barr PhD