Lyme Disease and Related Tick-Borne Infections - Symptoms

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Neurologic Symptoms

About 15% of untreated patients develop neurologic symptoms. They can occur in all stages of the disease and can affect any part of the nervous system.

Common Early Neurologic Symptoms. Most often, neurologic symptoms first appear while the initial skin rash is still present or within 6 weeks after its disappearance. Sometimes they are the first symptoms that the patient experiences. The most common neurologic symptoms may be headaches, sleep problems, and mood disturbance. Memory problems can also occur. Neurologic symptoms typically improve or resolve within a few weeks or months, even in untreated patients.

Bell's Palsy. In 5 - 10% of untreated Lyme patients, the facial nerve is affected, which results in Bell's palsy. This is a sudden weakness and drooping of the facial muscles and eyelid on one side of the face. Nerves around the facial area may also cause numbness, dizziness, double vision, and hearing changes. Another common neurologic problem is pain in the lower spine. It resembles low back pain from arthritis (although in the case of Lyme disease the skin near the spine may have abnormal sensations). Of note, Lyme disease has been observed in more than half the children who develop Bell's palsy.

Symptoms of Meningitis. In about 10 - 15% of patients, the infection takes place in the membranes that surround the brain and spinal cord (called meningitis). This can cause:

• Episodes of headache not relieved by over-the-counter medication
• Mild stiff neck
• Sensitivity to light

Symptoms of Lyme Encephalopathy. In some cases of untreated disease, the infection causes a condition called Lyme encephalopathy or neuroborreliosis. This causes the following symptoms:

• Unexplained mood changes
• Depression
• Trouble concentration and remembering
• Irritability
• Feelings of "pins and needles" or numbness in the arms or legs

Other Neurologic Symptoms.

• If the infection affects the white brain matter, symptoms resemble multiple sclerosis.
• If the infection occurs in the nerves affecting the skin, some patients experience pricking, tingling, or creeping feelings.
• Children have a higher risk than adults for neurologic effects on the eye. (This is still rare, however.)