Can Lyme Disease Cause Speech Problems? Slurred Speech, Stuttering, and Word-Finding Difficulty

Speech problems can occur in Lyme disease.
Slurred speech, stuttering, and word-finding difficulty have been reported.
Prompt neurologic evaluation is important when symptoms are new or worsening.

Can Lyme disease cause speech problems? Yes. Although speech and language problems are much less common than fatigue, facial palsy, peripheral neuropathy, or cognitive slowing, they have been reported in some patients with Lyme disease. Patients may describe slurred speech, stuttering, word-finding difficulty, slowed verbal fluency, or trouble expressing themselves.

These symptoms may arise through different mechanisms. In some patients, speech difficulty appears related to cognitive problems such as slowed processing speed, impaired memory retrieval, or reduced verbal fluency. In rare cases, Lyme neuroborreliosis may affect cranial nerves involved in speech, voice, swallowing, or vocal cord movement.

Because slurred speech or sudden speech changes can also signal stroke, seizure, migraine, medication effects, or another neurologic emergency, new or severe speech symptoms should always be evaluated promptly.

Speech Problems Reported in Lyme Disease

Speech-related symptoms reported in Lyme disease include:

• Slurred speech
• Stuttering or interrupted speech
• Word-finding difficulty
• Trouble naming familiar objects
• Slowed verbal fluency
• Difficulty organizing thoughts into words
• Hoarseness or voice changes
• Difficulty swallowing in rare neurologic cases

Some patients describe knowing exactly what they want to say but being unable to retrieve the correct word quickly. Others notice that speech becomes slower or less fluent during periods of fatigue, poor sleep, stress, or worsening neurologic symptoms.

Language Fluency Deficits in Post-Treatment Lyme Disease Syndrome

Recent studies of patients with post-treatment Lyme disease syndrome (PTLDS) have identified consistent deficits in memory and processing speed. Gorlyn and colleagues examined whether language fluency represented a separate cognitive problem or was simply a consequence of these other impairments.

In their study, Language Fluency Deficits in Post-treatment Lyme Disease Syndrome, the investigators evaluated 38 individuals with major depressive disorder, 59 healthy volunteers, and 31 individuals with PTLDS.¹

The PTLDS group had experienced symptoms for an average of 7.7 years and had waited a median of seven months before receiving a Lyme disease diagnosis and treatment.¹

Both the PTLDS and depression groups demonstrated deficits in verbal abilities, memory, and processing speed.

“Language fluency deficits were evident in PTLDS patients even after controlling for the significant effects of verbal ability, slowed processing speed, and memory difficulties on fluency performance.”

The authors concluded that language fluency appears to represent an independent neurocognitive deficit within the constellation of PTLDS symptoms rather than simply reflecting depression or generalized cognitive slowing.¹

Word-Finding Difficulty and Naming Problems

Difficulty finding the right word is one of the most common language complaints reported by patients with Lyme disease.

Svetina and colleagues evaluated 44 patients with Lyme borreliosis and 43 healthy controls using standardized neuropsychological testing. Patients with Lyme disease reported word-finding difficulty far more often than healthy controls and performed significantly worse on the Boston Naming Test.²

Specifically, 55% of Lyme patients reported word-finding problems compared with only 14% of controls. More than one-third of the Lyme group demonstrated naming scores in the impaired range.²

The investigators concluded that these naming difficulties appeared to reflect impaired retrieval of stored words rather than depression or reduced verbal fluency alone.²

Brain Fog or a Speech Disorder?

Patients often use the terms brain fog, speech problems, and memory loss interchangeably, but they are not the same.

Brain fog generally refers to slowed thinking, impaired concentration, mental fatigue, and slower information processing. A patient with brain fog may take longer to retrieve words because cognitive processing has slowed. This differs from a true language disorder, in which a person has difficulty producing or understanding speech despite otherwise intact thinking.

Word-finding difficulty, sometimes called a retrieval deficit, occurs when a patient knows the word they want to say but cannot access it quickly. This differs from aphasia, an acquired language disorder that affects speaking, understanding, reading, or writing, and from dysarthria, a motor speech disorder caused by weakness or impaired coordination of the muscles used for speech.

Although these problems may overlap, distinguishing among brain fog, retrieval deficits, aphasia, and dysarthria helps clinicians determine whether symptoms are more likely related to cognitive dysfunction, neurologic Lyme disease, stroke, or another neurologic disorder.

Can Lyme Disease Cause Slurred Speech?

Some patients ask whether Lyme disease can cause slurred speech.

The answer is yes—but it appears to be uncommon. Slurred speech (called dysarthria) has been reported in patients with neurologic Lyme disease, although it is not considered a typical presenting symptom.

It is important to distinguish slurred speech from word-finding difficulty. A patient with dysarthria knows exactly what they want to say but has difficulty producing clear speech because of impaired control of the muscles involved in speaking. By contrast, someone with word-finding difficulty struggles to retrieve the correct word despite having normal speech mechanics.

Because slurred speech can also result from stroke, transient ischemic attack (TIA), seizure, migraine, medication side effects, multiple sclerosis, Parkinson’s disease, or other neurologic disorders, it should never be assumed to be caused by Lyme disease without prompt medical evaluation.

Can Lyme Disease Cause Stuttering?

Some patients report new-onset stuttering or interrupted speech during Lyme disease.

Unlike word-finding difficulty, stuttering has received relatively little study in Lyme disease. It may occur alongside brain fog, slowed processing speed, fatigue, anxiety, or other neurologic symptoms, but the medical literature remains limited.

Although some individuals report improvement after treatment of the underlying illness, stuttering has many possible neurologic and non-neurologic causes. A careful medical evaluation is important before attributing it to Lyme disease.

Rare Voice and Swallowing Complications

Rare case reports describe Lyme neuroborreliosis affecting cranial nerves involved in voice production and swallowing.

One published case described bilateral recurrent laryngeal nerve palsy resulting in aphonia and vocal cord paralysis. The patient improved following treatment with intravenous ceftriaxone.³

Another report described dysphagia associated with Lyme disease accompanied by facial palsy, hearing loss, vocal cord paralysis, and swallowing impairment. The authors emphasized that dysphagia is an uncommon manifestation but should be considered when unexplained swallowing problems occur in the setting of suspected Lyme neuroborreliosis.⁴

These reports illustrate that Lyme neuroborreliosis can, on rare occasions, involve cranial nerves responsible for speech, voice, and swallowing. However, these remain exceptional presentations rather than common manifestations of Lyme disease.

What Does the Broader Literature Show?

A recent review of the neuropsychiatric manifestations of Lyme disease concluded that some studies demonstrate impairments in verbal fluency, attention, processing speed, and memory, while others have reported limited or inconsistent long-term cognitive effects.⁵

Overall, the evidence suggests that speech and language complaints can occur in selected patients, particularly those with neurologic Lyme disease or post-treatment Lyme disease syndrome. However, the current literature does not support assuming that every speech problem is caused by Lyme disease.

The most balanced interpretation is that Lyme disease belongs in the differential diagnosis when speech problems occur together with compatible neurologic symptoms, tick exposure, or other clinical features of Lyme disease. Careful evaluation remains essential to distinguish Lyme disease from stroke, seizure, migraine, medication effects, structural neurologic disease, and other causes.

When Speech Problems Need Urgent Evaluation

Speech changes should always be taken seriously.

Urgent medical evaluation is especially important if speech symptoms are sudden, severe, or accompanied by:

• Facial drooping
• Weakness or numbness on one side of the body
• Confusion
• Severe headache
• Difficulty swallowing
• Loss of balance or coordination
• Vision changes
• Seizure-like activity
• Shortness of breath or voice changes associated with breathing difficulty

These symptoms may indicate a neurologic emergency and should not automatically be attributed to Lyme disease.

Clinical Perspective

In my practice, patients with Lyme disease frequently describe brain fog, slowed thinking, memory problems, and difficulty retrieving words. Many explain that they know exactly what they want to say but cannot quickly find the right word.

When speech problems occur together with fatigue, headaches, facial palsy, neuropathy, dizziness, or other neurologic symptoms, Lyme disease belongs in the differential diagnosis—particularly in patients with a history of tick exposure or previous Lyme disease.

At the same time, speech disorders have many possible causes. A careful history, neurologic examination, and appropriate testing are essential before concluding that Lyme disease is responsible.

Frequently Asked Questions

Can Lyme disease cause speech problems?

Yes. Some patients with Lyme disease report speech or language problems, including word-finding difficulty, slowed verbal fluency, slurred speech, or trouble expressing themselves. These symptoms have been reported in neurologic Lyme disease and post-treatment Lyme disease syndrome (PTLDS), although they are much less common than fatigue, facial palsy, or joint symptoms.

Can Lyme disease cause slurred speech?

Yes, although it appears to be uncommon. Slurred speech (dysarthria) has been reported in neurologic Lyme disease. Because sudden slurred speech may also indicate stroke or another neurologic emergency, it should always be evaluated promptly.

Can Lyme disease cause stuttering?

Some patients describe stuttering or interrupted speech during Lyme disease, often together with brain fog or word-finding difficulty. However, research on stuttering in Lyme disease is limited, and many other neurologic conditions can produce similar symptoms.

Can Lyme disease cause word-finding difficulty?

Yes. Studies have shown that some patients with Lyme borreliosis experience difficulty retrieving words and naming familiar objects. These problems may reflect slowed retrieval of stored information rather than depression or reduced verbal ability alone.

Are speech problems in Lyme disease permanent?

Not necessarily. Some patients improve as the underlying illness is treated, while others continue to experience cognitive symptoms as part of PTLDS. Recovery depends on the underlying cause, duration of illness, severity of neurologic involvement, and the presence of other medical conditions.

Clinical Takeaway

Speech and language problems have been reported in Lyme disease, particularly in patients with neurologic Lyme disease or post-treatment Lyme disease syndrome. These symptoms may include word-finding difficulty, slowed verbal fluency, slurred speech, or, more rarely, vocal cord dysfunction. Because speech changes can also signal serious neurologic conditions, prompt medical evaluation is essential.

Related Articles

Learn more about neurologic Lyme disease, cognitive symptoms, and other nervous system complications.

• How Does Lyme Disease Affect the Brain?
• Brain Fog in Lyme Disease
• Neurologic Lyme Disease
• Should Lyme Disease Be Added to the Causes of Vocal Cord Paralysis?
• Neuropsychiatric Lyme Disease

References

1. Gorlyn M, Keilp JG, Fallon BA. Language Fluency Deficits in Post-treatment Lyme Disease Syndrome. Arch Clin Neuropsychol. 2022.
2. Svetina C, Barr WB, Rastogi R, Hilton E. The neuropsychological examination of naming in Lyme borreliosis. Appl Neuropsychol. 1999;6(1):33-38.
3. Furtner M, Patjas M, Frauscher B, Schmutzhard E, Willeit J. A case of Lyme neuroborreliosis with bilateral recurrent laryngeal nerve palsy. JRSM Short Rep. 2010;1(6):56.
4. Kim P, Lim SH, Lee JI, et al. Dysphagia due to Lyme disease: A case report. Brain Neurorehabil. 2024;17:e25.
5. Šegždaitė G, Aliukonytė O, Pociūtė K. Neuropsychiatric manifestations of Lyme disease: A literature review of psychiatric and cognitive impacts. Acta Med Litu. 2025;32(1):6-21.

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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention