Lyme disease is a tick-borne infection caused by the bacterium Borrelia burgdorferi. The illness can manifest in a variety of ways, and its symptoms may affect multiple organ systems.
A distinctive circular, bull’s eye rash develops around the site of the tick bite within days or weeks in 70–80% of patients. If you don’t have a rash but your doctor believes you may still have contracted the infection, the disease must be identified based on your symptoms and other factors, such as your history of tick bites and visiting high-risk areas.
The early symptoms of Lyme disease are usually flu-like. They can be very mild and hardly noticeable in those with healthy and strong immune systems. In its initial stage, the infection can usually be successfully treated with a course of antibiotics. If the illness is not diagnosed, more serious symptoms may develop later, including joint, heart and neurological problems. Signs that the infection has spread to the brain and the nervous system are memory loss, progressive cognitive decline, difficulty concentrating, facial paralysis, and pain and numbness in the limbs. Severe headaches and visual disturbances may also occur if the illness remains untreated for a long period of time.
Since the symptoms are disparate and non-specific, Lyme disease is often misdiagnosed as another condition. The illness may be confused with fibromyalgia, chronic fatigue syndrome, multiple sclerosis, dementia, Alzheimer’s disease, Parkinson’s disease and other neurological and psychiatric conditions.
There are currently no 100% reliable laboratory tests available to identify Borrelia burgdorferi infections. Although some diagnostic tests do exist, the results of these are often inaccurate, especially during the initial weeks following the tick bite.
What Are Acute and Chronic Lyme Disease?
Before delving into the neurological symptoms of Lyme disease, it’s important to understand the difference between the acute and chronic forms of the illness. When an infected tick bites someone and the microbes first enter the person’s body, their immune system starts to produce antibodies against the bacteria. People with robust immune function may not even recognise any signs of infection at this stage.
It’s normally quite easy to completely cure Lyme disease if it’s diagnosed early enough. However, if the infection isn’t recognised, the bacteria will continue living and gradually proliferating in the cells of the host without causing any significant symptoms. This phase can last for months or even years.
Chronic Lyme disease results from the dissemination of the bacteria into many different areas of the body. Eventually, infection can spread to all tissues and organs, and it doesn’t spare the brain either.
Patients may not experience any symptoms until their immune function is disrupted by another health condition or some environmental factors. When the body’s natural defences weaken, the bacteria begin to thrive. Possible symptoms presenting at this stage include, but are not limited to, extreme fatigue, joint pain, muscle aches and cognitive impairment.
The chronic phase of Lyme disease can last for many years and even a lifetime if not treated properly. The continued dysfunction of the immune system may lead to more and more severe symptoms.
Does Lyme Disease Have Any Neurological Symptoms?
When Lyme disease progresses to the chronic stage and the bacteria infect the nervous system, neuroborreliosis may develop. So what is neuroborreliosis? Put simply, it’s a neurological disorder affecting the brain, spinal cord and nerves.
Symptoms of neuroborreliosis include dementia, sleep disorders, attention deficit, decreased verbal fluency, dyslexia and cranial nerve abnormalities. Some patients also experience mental health problems, such as depression, mood swings, anxiety and panic attacks. In children, some common signs of neuroborreliosis are learning difficulties, changes in behaviour, headaches and sleep disturbances.
In terms of the relationship between Lyme disease and the brain, health professional estimate that Lyme disease seriously affects brain function in approximately 15% of patients. However, the actual number may be higher, as at least a few thousands of cases are believed to be undiagnosed each year.
A small percentage of Lyme patients have ongoing neurological symptoms despite having undergone timely antibiotic treatment. This so-called post-treatment Lyme disease syndrome likely results from a severe inflammation of the brain.
How Is Chronic Lyme Disease Diagnosed?
Doctors usually diagnose Lyme disease by considering various factors, such as any obvious physical signs, symptoms and the patient’s history of tick bites or visits to high-risk areas. Blood tests may also aid diagnosis, especially if the illness has entered the chronic stage.
An MRI scan of the brain may also be recommended for patients with symptoms of neuroborreliosis. The scan may reveal lesions similar to those caused by multiple sclerosis. Spine may might also be seen.
Cerebrospinal fluid testing can help detect the presence of Borrelia burgdorferi. Other diagnostic methods include neuropsychological, neurocognitive and nerve conduction tests.
Can Neuroborreliosis Be Cured?
The successful management of chronic Lyme disease and neuroborreliosis requires a holistic and largely personalised approach. Treatment involves the use of intravenous antibiotics, possibly combined with anti-inflammatory medication, immune modulators and hormonal therapies.
Patients may also need to consider making some lifestyle changes in order to help fight inflammation. A diet rich in fatty fish, leafy green vegetables, nuts and fruits can contribute to recovery. Certain nutritional supplements may also be helpful.