Neurologic Lyme Disease: Understanding Nervous System Symptoms

Neurologic Lyme disease occurs when infection with Borrelia burgdorferi affects the brain, spinal cord, or peripheral nerves. These neurologic manifestations represent some of the most complex symptoms of Lyme disease and can involve both the central and peripheral nervous system.

Patients with neurologic Lyme disease may experience symptoms such as headaches, brain fog, memory problems, dizziness, nerve pain, or facial palsy. Because these symptoms resemble many other neurologic disorders, Lyme disease may be overlooked during the diagnostic process.

This page provides an overview of neurologic Lyme disease and links to articles discussing specific neurologic symptoms associated with Lyme infection. For a broader overview of symptoms affecting multiple body systems, see the Lyme disease symptoms guide.

Common Neurologic Lyme Disease Symptoms

• Brain fog and slowed thinking
• Memory problems and cognitive dysfunction
• Headaches
• Dizziness or balance problems
• Nerve pain (neuropathy)
• Radicular pain involving the back or limbs
• Facial palsy (Bell’s palsy)
• Sensory disturbances such as tingling or burning sensations

Some patients also develop more complex neurologic complications involving inflammation of the nervous system, including meningitis, encephalopathy, and peripheral neuropathy.

In children, neurologic Lyme disease may present differently than in adults. Behavioral changes, school difficulties, headaches, or facial palsy may be early clues. For more discussion see pediatric Lyme disease.

Neurologic Symptom Patterns

Neurologic Lyme disease can affect multiple parts of the nervous system. Symptoms often cluster into several recognizable patterns involving vision, autonomic regulation, cognition, or peripheral nerve function.

• Visual symptoms – blurred vision, double vision, or light sensitivity related to optic nerve or cranial nerve involvement. See eye symptoms of Lyme disease.
• Autonomic symptoms – dizziness, palpitations, and orthostatic intolerance related to nervous system regulation of heart rate and blood pressure. See autonomic dysfunction in Lyme disease.
• Cognitive symptoms – brain fog, slowed thinking, and memory problems affecting concentration and mental clarity. See brain fog in Lyme disease.
• Peripheral nerve symptoms – neuropathy, radicular pain, or abnormal sensations such as burning or tingling in the limbs.

Articles on Neurologic Lyme Disease

• Brain fog in Lyme disease
• Lyme disease neuropathy
• Radicular pain due to Lyme disease
• Facial palsy in Lyme disease
• Cognitive problems associated with Lyme disease
• Small fiber neuropathy and Lyme disease

Why Neurologic Lyme Disease Is Often Missed

Neurologic Lyme disease can be difficult to recognize because the symptoms overlap with many other neurologic conditions. Patients may initially be evaluated for disorders such as multiple sclerosis, chronic fatigue syndrome, fibromyalgia, migraine disorders, or psychiatric illness before Lyme disease is considered.

To learn more about these diagnostic challenges, see our page on Lyme disease misdiagnosis.

Related Hubs

• Symptoms Guide
• Autonomic Dysfunction
• Eye Symptoms
• Persistent Lyme Disease Mechanisms
• Recovery from Lyme Disease

Editor’s note: In my clinical experience, neurologic symptoms are among the most concerning manifestations of Lyme disease and often prompt patients to seek specialized medical evaluation.