Chronic neurological Lyme disease or co-morbid conditions?

man with fatigue holding head

Some patients with chronic neurological Lyme disease continue to have persistent, debilitating symptoms following treatment. A recent study confirmed the severity of chronic symptoms in this patient population but unfortunately dismissed the symptoms, attributing them to various co-morbid conditions, rather than Lyme disease. [1]

The study, “Patient-reported outcome after treatment for definite Lyme neuroborreliosis” by Eikeland and colleagues, describes 258 patients treated for definite Neurologic Lyme disease. Many of them with chronic neurological lyme disease remained symptomatic an average of 5 years after their initial treatment.

According to the authors, a higher proportion of their chronic neurological Lyme disease patients reported severe fatigue. Furthermore, “Mental health-related quality of life was poorer among [neuroborreliosis] NB-treated patients than in normative data.”

Although many of the patients’ symptoms are consistent with those found in chronic neurological Lyme disease, the authors attributed the symptoms to co-morbid illnesses, based on a retrospective review of the medical records.

READ MORE: Six cases of neuroinvasive Lyme disease

The symptoms included: radiating pain, general pain, fatigue, facial palsy, malaise, dizziness and/or unsteadiness, headache, numbness in arm and/or leg, memory and/or concentration problems, paresis in arm and/or leg, and diplopia.

[bctt tweet=”Symptoms due to chronic neurological Lyme disease or co-morbid conditions?” username=”DrDanielCameron”]

Co-morbid conditions listed for these patients included: fibromyalgia, allergies, depression or anxiety, multiple sclerosis, systemic disease sarcoidosis, systemic lupus erythematosus, Sjögren’s syndrome, rheumatoid arthritis, chronic fatigue syndrome, Parkinson’s disease, thyroid dysfunctions, and cancer.

Note: The study was not designed to assess whether the patient, in fact, had the co-morbidity listed in their records or instead had complications of chronic neurological Lyme disease.

  1. Eikeland R, Ljostad U, Helgeland G, et al. Patient-reported outcome after treatment for definite Lyme neuroborreliosis. Brain Behav. 2020:e01595.

6 Replies to "Chronic neurological Lyme disease or co-morbid conditions?"

  • Evan
    06/07/2020 (5:18 pm)

    How likely is that the persisting symptoms are due to persistent borrelial infection of the brain?

    • Dr. Daniel Cameron
      06/08/2020 (8:18 am)

      Researchers are still working on the mechanism for neurologic Lyme disease.

      • Sheryl
        06/20/2021 (8:52 pm)

        My sister was diagnosed with chronic Lyme 1.5 years ago. She has developed a mold toxicity and heavy metal toxicity at the same time and is being told she has the moldy gene that effects her ability to chelate on her own. Have you heard of this combination of illnesses previously with chronic Lyme disease?

        • Dr. Daniel Cameron
          06/22/2021 (8:36 am)

          I have individuals with Lyme disease and tick borne illnesses who have been advised that their illness in related to Mold. I have found that treating these individuals for a tick borne infection first rather than a mold approach has been helpful.

          • Dan
            12/12/2023 (4:57 pm)

            Hello Dr Cameron.

            I have been ill since 2015 which was diagnosed as lyme and babesia Duncani on tests. I did pulsed abx up until 2018 and recovered 50%. I was told the remaining symptoms was residual damage.

            Then in 2020, my turbinates enlarged (and have been ever since), my gp prescribed clarithromycin and 2 days after finishing the course something major happened to me. I lost peripheral vision, went confused, shaking and like my body was in shock. Later in hospital I developed a major migraine behind my eye, vomiting. Subsequently lost my ability to talk, words were slurred and jumbled and I couldn’t make sense of what docs were saying. I couldn’t read or write.

            All MRI/CT was normal, and LP was also normal. They put me on IV ceft for two days and I eventually started feeling better although it took me some time to read again, it was so odd and never experienced anything like it.

            They discharged me with migraine which I know is false. When I got home I began detiorating again and began reacting to antibiotics which I never did before 2020. I had siesure like episodes which happened around evening time every day where my limbs would become heavy and speech slurred. This gradually improved with abx. I also got a crohns diagnosis shortly after.

            I’ve been fighting to stay alive ever since. So many symptoms and I can’t seem to get better. Every time I come off abx after 4 days my skin burns and siesure like things gradually come back. Abx seem to control only this but won’t get me better. My neurological symptoms are so bad.

            I’ve tried searching for an LLMD that can help in complex cases. Is this something you think you could help with?


          • Dr. Daniel Cameron
            12/14/2023 (6:37 am)

            You are not alone. I am glad you have ruled out causes. I have had patients where they respond to treatment even if they did not resolve their illness with IV ceftriaxone. I have found retreatment for Babesia duncani helpful.

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