Chronic neurological Lyme disease or co-morbid conditions?
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. 
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.
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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.Symptoms due to chronic neurological Lyme disease or co-morbid conditions? Click To Tweet
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.
- Eikeland R, Ljostad U, Helgeland G, et al. Patient-reported outcome after treatment for definite Lyme neuroborreliosis. Brain Behav. 2020:e01595.
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