Can Lyme disease cause speech issues?
WORD-FINDING TROUBLE—BUT YOU KNOW WHAT YOU WANT TO SAY?
COULD IT BE LYME DISEASE?
“I know what I want to say—but I can’t find the words.”
Some patients with Lyme disease describe a frustrating change in speech. Words feel just out of reach. Conversations slow down. Thoughts don’t come out clearly.
Quick Answer: Lyme disease can affect speech and language, including word-finding difficulty and reduced verbal fluency.
Clinical Insight: Language problems in Lyme disease may represent a distinct neurologic issue—not just a byproduct of memory or attention deficits.
Lyme disease has been associated with a wide range of neurocognitive symptoms, including problems with attention, memory, and speech.
Recent studies examining patients with post-treatment Lyme disease syndrome (PTLDS) have found consistent deficits in memory and processing speed.
An important question remains: are language problems simply part of broader cognitive slowing, or do they represent a separate neurologic issue?
Gorlyn and colleagues evaluated three groups: individuals with major depressive disorder (MDD), healthy volunteers, and individuals with PTLDS.
The PTLDS group had a long duration of illness and significant delays in diagnosis and treatment.
Language fluency deficits in PTLDS
The researchers found that both the PTLDS and MDD groups showed deficits in verbal ability, memory, and processing speed.
“…language fluency deficits were evident in PTLDS patients even after controlling for verbal ability, slowed processing speed, and memory difficulties.”
This suggests that language problems are not simply caused by broader cognitive deficits.
“Language problems are a distinct area of cognitive deficit in PTLDS, and not a function of depressed mood or other cognitive problems.”
What this means clinically
These findings reflect what many patients report: difficulty finding words, slowed speech, or trouble expressing thoughts clearly.
This pattern overlaps with other neurologic Lyme disease symptoms, where cognitive processing is affected.
Importantly, these language issues may occur even when mood symptoms or general cognitive measures do not fully explain them.
Are speech problems temporary?
The study was not designed to determine whether language deficits are temporary or long-lasting.
However, many participants had persistent symptoms for years despite treatment.
The underlying biologic mechanism also remains unclear.
Other research has described cognitive slowing, difficulty with information retrieval, and disruption in everyday communication in Lyme disease.
Frequently Asked Questions
Can Lyme disease cause speech problems?
Yes. Lyme disease can affect language, including word-finding difficulty, slowed speech, and reduced verbal fluency.
Are speech problems just brain fog?
Not always. Research suggests language deficits may be a distinct neurologic issue, not just part of general cognitive slowing.
Can Lyme disease mimic depression?
Yes. Some cognitive symptoms overlap with depression, but language deficits in PTLDS appear to persist even when mood is considered.
Do speech problems improve?
They may improve over time, particularly as overall neurologic function stabilizes, though recovery varies.
References
- Gorlyn, M., Keilp, J. G., & Fallon, B. A. (2022). Language fluency deficits in post-treatment Lyme disease syndrome. Archives of Clinical Neuropsychology. https://doi.org/10.1093/arclin/acac089
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
I experienced Language deficits for years before my Lyme diagnosis and treatment. Forgetting what I was talking about, slurred words. Tounge failure the pronunciation. Since treatment, I do not do most of any of that now. with slight conversation forgetfulness. But very acceptable. Thanks for sharing.
I am glad your language issue improved with treatment.
What was your treatment? I still have language deficiency after 3 months oral antibiotics doxycycline.
My friend has the worst strain of this disease , RST 1 type A , she’s had it for 12 years, seen many doctors, tried the antibiotics , but made her sick, so she stopped . It has entered her bloodstream, she now has Parkinson’s , don’t know how long she has, Her husband is still searching for an answer ….. cure??
I have had patients who fail treatment. I also have patients who have done well with a different approach
Have a very good friend that suffered from a “spinal infection” that caused him to spend weeks in the hospital. Upon discharge, he was attached to a highly-concentrated anti-biotic IV bag. The spinal infection supposedly cleared itself after said treatments, but shortly thereafter he developed speech impediments. His thought processing and social skills are normal, but his ability to speak has deteriorated over the past 8-10 months. Neurologists have diagnosed him with Aphesia – which, I understand to be a facet of dementia? I’m chiming into this Blog to ask…might there be a correlation between his spinal infection from 2yrs ago & his speech issues? Might his symptoms be connected/attributable to a missed Lyme Disease diagnosis instead of some strange spinal infection & shortly there-after diagnosis of Aphesia? Would there be any change to treatment/therapy efforts? From what I have learned, Aphesia is not a “curable” diagnosis?
I suspect you are referring to as aphasia, a language finding seen in individuals with neurologic findings. There are a number of causes.
Songwriter and actor Kris Kristofferson , for at least 2 years before his death, suffered from worsening aphasia or almost complete loss of the ability to speak, except with great difficulty, which was a tragedy for a man who was one of the finest lyricists ever. He had time disease symptoms for more than a decade before he was diagnosed. But it seems to me he also had symptoms of fronto- temporal dementia. Is it possible that he could have had both?
I am not able to comment on the specifics of Kris Kristofferson as he was not under my care. Lyme disease appeared to be a significant part of his illness as he returned to public life after treatment
Since 1992-present I have had bilateral hyperacusis caused by neurologic Lyme disease. When noise increases or overlaps (multiple audio stim simultaneously) I stutter and slur my speech. I have to tell people on the phone that sounds from the phone itself make me stutter, etc. I take neurontin and lamotrigine for hyperacusis. When neurontin dose wears off (I don’t have to check the time) everything gets very loud. (Have unsuccessfully tried chlomipramine for hyperacusis).
But after timely and longterm IV abx the speech impairment persists. On neuropsych testing, my vocab was in the 98th percentile; my verbal fluency was in the 4th percentile. Reached Dr Brian F and presented w impaired expressive fluency. Remains unchanged. It is exacerbated by multiple sound and light stimuli.
I was bitten and documented and actually timely (though under-) treated in 1989 (first bite w large EM) — all rheumatologic but sans dysfluency (sp?); only the second bite in 92 (ie again EM and well-treated) cause disabling neurologic symptoms, encephalopathy, hyperacusis, etc) and this second bite induced fluency problems. From 1992-today, fluency deficits (?) persist: stuttering, slurring of consonants to point of getting verbally stuck on entire words, and when very exhausted, an inability to simply “make words”. Despite language issues, Can finally read short fiction—took years to get here due to probs w memory & attn confusion. Have MA in English (from Columbia)
Have not pursued speech therapy.
The point: I actually attribute speech impairment to Lyme hyperacusis (because that is what seems to most frequently trigger/worsen it)
I have Lyme disease patients with hyperacusis. Thanks for sharing your insight.
I have lyme in my voice for a year untreated 17 drs . good one bad the next it driving me crazy
I hope you find your voice