Lyme disease was first reported in 1975 in the town of Lyme in Connecticut. It’s a tick-borne illness caused by infection with the bacterium Borrelia burgdorferi. It has a wide range of possible symptoms affecting multiple organ systems. A characteristic circular rash often develops around the site of the tick bite within days or weeks. However, in 20–30% of cases there is no rash, so the disease must be identified by other symptoms.
Initially, Lyme patients usually experience flu-like symptoms. In its early stages, the infection is usually successfully cured with antibiotics. If left untreated, more serious symptoms may develop months or years later, such as arthritis, heart problems, meningitis and neurological disorders. Symptoms affecting the nervous system include memory loss, difficulty concentrating, facial paralysis, and pain and numbness in the limbs. Severe headaches and visual disturbances are also common as the illness progresses.
Since the symptoms overlap with those of various other diseases, Lyme is sometimes misdiagnosed as chronic fatigue syndrome, fibromyalgia, multiple sclerosis, dementia, Alzheimer’s disease, Parkinson’s disease, and other psychiatric conditions.
There are currently no absolutely reliable diagnostic tests available for Lyme disease. Although lab tests are available, the results are often inaccurate. During the first weeks after infection, there’s a 60% rate of false negative results.
Acute vs. Chronic Lyme Disease
There are some important differences between acute and chronic Lyme disease. When infection occurs and the bacteria enter the body, the immune system recognizes the microbes as harmful and begins fighting them. If the immune system is strong and robust, the initial symptoms may be very mild, and sometimes there won’t be any symptoms at all. This is why people often don’t even realize they’ve been infected.
In its early stages, Lyme disease is usually treated successfully with antibiotics. But if the infection remains undiagnosed, the bacteria can go on living inside the cells without causing any trouble for a long time. As they travel to other tissues and organs, including the brain, they eventually disperse throughout the body. The only time symptoms might present is when the immune system weakens due to illness, extreme stress, or some other reason. This is when the bacteria start to flourish, causing a chronic infection.
Chronic Lyme disease occurs when the entire microbiome (the collection of “good” microbes living in the body) is disrupted. After this has happened, the immune system continues to dysfunction, which can lead to many different types of symptoms. This chronic phase can even last a lifetime.
Headache, depression, anxiety and mood swings are some of the symptoms of neuroborreliosis.
How Lyme Disease Affects the Brain
Lyme disease has profound effects on the brain in about 15% of patients. According to some sources, this percentage may even be higher, since thousands of cases are likely to remain undiagnosed every year.
Neuroborreliosis is the name for the neurological disorder caused by Lyme disease. The symptoms of neuroborreliosis include memory impairment, attention deficit, sleep disturbances, cranial nerve abnormalities, dyslexia, decreased verbal fluency, and sensitivity to light. In some cases, depression, anxiety, panic attacks, mood swings, hallucinations, and progressive dementia may also occur. In children, the most common symptoms of neuroborreliosis are headaches, behavioral changes, learning difficulties, and sleep disorders.
A small number of patients experience neurological symptoms after early antibiotic treatment for Lyme disease. This phenomenon is referred to as “post-treatment Lyme disease syndrome” and is probably caused by a widespread inflammation of the brain.
Neurological Lyme Disease Diagnosis and Treatment
Lyme disease is normally diagnosed based on a combination of factors, such as symptoms, any physical signs, history of tick bites or potential exposure to infected ticks, and laboratory tests.
Patients with chronic neurological symptoms may benefit from a brain MRI scan and late-stage Lyme disease testing, such cerebrospinal fluid testing. These can help determine the presence of Borrelia burgdorferi. Brain scans may show lesions similar to the ones seen in multiple sclerosis. Spine lesions are also sometimes observed. Other diagnostic methods include neurocognitive tests, nerve conduction studies, and neuropsychological testing.
Brain imaging techniques may be used to aid the diagnosis of neurological Lyme disease
Chronic and neurological Lyme disease is the result of weakened immunity, decreased cellular function and environmental and lifestyle factors. Therefore, treatment requires a holistic and personalized approach, addressing each cause separately, rather than focusing on specific symptoms.
Intravenous antibiotics are the main component of standard treatment for neuroborreliosis. Additional options to help boost the effectiveness of antibiotics include nonsteroidal anti-inflammatory medication, immune modulators, antiviral drugs, hormonal therapies, and nutritional supplements.
Patients are also often asked to consider making some lifestyle changes. For instance, an anti-inflammatory diet rich in leafy green vegetables, fatty fish, nuts, and fruits can help reduce the autoimmune effects of the illness.