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May 15, 2024 · Treatment. Facial palsy is treated with oral antibiotics and Lyme meningitis/radiculoneuritis can either be treated with oral or intravenous antibiotics, depending on severity (see tables below). Most people with Lyme disease respond well to antibiotics and fully recover.
- Overview
- Symptoms of neurologic Lyme disease
- Cause of neurologic Lyme disease
- Treatment for neurologic Lyme disease
- Diagnosing neurologic Lyme disease
- Outlook
- Summary
Neurologic Lyme disease occurs when Lyme disease bacteria invade and affect the nervous system. Symptoms include numbness, pain, facial droop, neck pain, vision changes, and more.
Lyme disease is transmitted through an infected tick’s bite. The infection can be chronic and it usually affects the joints and causes flu-like symptoms. The bacteria can also affect the cranial, peripheral, and central nervous system (CNS), causing a range of neurological symptoms.
Neurologic Lyme disease — also called neuroborreliosis or Lyme neuroborreliosis — occurs in up to 15% of people with Lyme disease. In every 100 cases of Lyme disease, there are approximately:
•nine with facial palsy
•four with radiculoneuropathy
•two with meningitis or encephalitis
Neurological symptoms often occur early in the course of Lyme disease. They typically occur 3-5 weeks from the initial bite and after the flu-like symptoms that people commonly experience at the start of the infection.
Lyme neuroborreliosis may affect the CNS, including the brain and spinal cord. It may also affect the peripheral nervous system (PNS), including motor and sensory nerves.
Various inflammatory conditions can occur due to neurologic Lyme disease. However, a classic triad commonly appears in a typical nervous system Lyme disease. This triad includes:
•Radiculoneuritis: This is the simultaneous inflammation of the motor and sensory spinal nerve roots. It can result in muscle weakness or paralysis and sensory symptoms, including tingling, numbness, and sharp pain.
•Cranial neuritis: This occurs when the cranial nerves become inflamed. These nerves emerge from the brainstem. They are necessary for essential functions, including:
•eye movements
Lyme disease is transmitted through a bite of blood-feeding hard-shelled Ixodes ticks. However, they are usually attached for at least 36-48 hours before the bacterium is transmitted.
Different types of Ixodes are common in other parts of the world, and there are three types of species causing Lyme disease. Typically, the Borellia burgdorferi bacterium causes Lyme disease in the United States.
Most people with Lyme disease respond well to antibiotics such as doxycycline and ceftriaxone. However, doxycycline is not approved by the Food and Drug Authority (FDA) for children under 8 years old.
The typical duration of treatment is from 14-21 days. However, early treatment may last 7–14 days.
An infectious disease specialist may decide and adjust the antibiotic regimen based on a person’s:
•age
•underlying health conditions
•medical history
The most tell-tale sign of Lyme disease is a circular bulls-eye-like rash called erythema migrans. However, it is not always present.
Lyme disease can be challenging to diagnose because it can have many nonspecific symptoms that are similar to symptoms of other conditions.
More importantly, neurological Lyme disease can resemble and be mistaken for many other conditions. Therefore, it is important for a healthcare professional to make a correct diagnosis. Some of these conditions include:
•multiple sclerosis (MS)
•chronic fatigue syndrome (CFS)
•Bell’s palsy
Many individuals with Lyme disease respond well to treatment and experience full recovery.
However, late-stage Lyme neuroborreliosis and complications may occur if healthcare professionals do not detect Lyme disease early. The prevalence of late-stage symptoms varies, and there are different reasons for prolonged symptoms.
It is common for people with late-stage Lyme disease to experience permanent joint and nervous system damage to varying degrees.
Residual symptoms are not uncommon in neurological Lyme disease and when treatment is delayed.
Around 10-20% of people with Lyme disease experience persistent symptoms 6 months after receiving antibiotics and other treatments. This condition is called post-treatment Lyme disease syndrome. It may be an inflammatory or autoimmune response to the infection.
Learn more about why Lyme disease symptoms persist for some people.
Neurologic Lyme disease occurs when the bacteria causing Lyme disease invade the nervous system, leading to neurological symptoms and inflammatory conditions. These vary widely from tingling and numbness to neuritis and meningitis.
It typically occurs in individuals whose Lyme disease is not treated promptly with antibiotics.
Early recognition and prompt treatment may prevent the infection from progressing to more severe stages. However, this may be challenging due to the difficulty of diagnosing Lyme disease accurately.
A person should carefully monitor suspected tick bites and consult a healthcare professional if they think they are at risk of Lyme disease. A healthcare professional can conduct tests to help diagnose the condition.
Apr 6, 2024 · Treatment. Prevention. Lyme neuroborreliosis (LNB), also known as neurological Lyme disease, is a complication of Lyme disease affecting the central nervous system. It is caused by the spread of the Borrelia bacterium to the brain and spinal cord, causing nerve pain, numbness, double vision, facial palsy, and other symptoms.
Feb 27, 2020 · Preface. Lyme borreliosis is the most common tick-borne infectious disease in Europe. A neurological manifestation occurs in 3–15% of infections and can manifest as polyradiculitis, meningitis and (rarely) encephalomyelitis. The disease can be treated with antibiotics.
- Sebastian Rauer, Stephan Kastenbauer, Heidelore Hofmann, Volker Fingerle, Hans-Iko Huppertz, Klaus-P...
- 10.3205/000279
- 2020
- Ger Med Sci. 2020; 18: Doc03.
The mainstay of treatment is with oral (pill) antibiotics, but intravenous antibiotics are sometimes indicated for more difficult to treat cases of neurologic-Lyme disease, such as meningitis, and cases of late Lyme arthritis. Why are antibiotics the first line of treatment for Lyme disease?
Jun 18, 2021 · Lymphocytic/monocytic meningitis, facial nerve palsy, and radiculoneuritis constitute the classic triad of acute, early neurologic Lyme disease. These manifestations may occur alone or in combination; in the United States radiculoneuritis is diagnosed less commonly than meningitis or facial palsy.
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