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 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.