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A case report by Lazaro and Butt, published in the International Medical Case Reports Journal, describes a 67-year-old patient with Lyme disease and femoral neuropathy.¹ This is believed to be the first reported case of isolated femoral neuropathy triggered by Lyme disease.
Femoral neuropathy, also referred to as femoral nerve dysfunction, involves a loss of movement or sensation in parts of the legs due to damage to the femoral nerve.
The patient, who lived in central New York, a region endemic for Lyme disease, developed a large erythema migrans (EM or bull’s-eye) rash on his chest, which lasted for 3 weeks, along with swelling of his left knee.
An IgG Western blot test for Lyme disease was positive, and he was treated with a 4-week course of doxycycline.
“Shortly after the completion of the doxycycline therapy, this patient began complaining of gait difficulties and frequent falls, as well as intermittent painful cramps in his right thigh.”
An electromyography (EMG) test, which measures muscle response or electrical activity when a nerve muscle is stimulated, indicated the patient had a femoral neuropathy.
READ MORE: Small fiber neuropathy in Lyme disease and COVID-19
“A year after the onset of the disease, and following an extensive course of physical therapy, this patient was able to return to his full-time work as an attendant in a local store,” writes Lazaro.
“We firmly believe that the femoral neuropathy and Lyme disease seen in this patient were causally related,” the authors conclude.
This patient’s femoral neuropathy could have developed into a multifocal neuropathy, which involves damage to 2 or more different nerve areas, if the antibiotic treatment had been delayed.
“… if not for a timely institution of antimicrobial therapy, [the femoral neuropathy] might have evolved into a more overt or disseminated infectious or parainfectious process, affecting both the peripheral and central nervous systems.”
The authors’ findings suggest that femoral neuropathy is “analogous to facial nerve palsy as a presenting symptom of Lyme disease without the overt involvement of other cranial or peripheral nerves.”
The list of peripheral neuromuscular segments affected in Lyme disease has grown to include the nerve cell bodies and their axons, all of the cranial nerves except the olfactory nerve, the nerve roots, the brachial and lumbosacral plexuses, and the peripheral nerves, either in isolation or as part of a multiple or diffuse neuropathic process.²-³
Related Articles:
Autonomic dysfunction, small fiber neuropathy and Lyme disease
Chronic inflammatory demyelinating polyneuropathy case resolved with antibiotics
References:
- Lazaro RP, Butt K. Femoral mononeuropathy in Lyme disease: a case report. Int Med Case Rep J. 31 July 2019, Pages 243-247.
- Halperin JJ. Lyme disease and the peripheral nervous system. Muscle Nerve. 2003;28:133–147.
- Logigian EL. Peripheral nervous system Lyme borreliosis. Semin Neurol. 1997;17:25–29.
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This happened to my mom as well with Lyme Disease. Her femoral neuropathy was bilateral and mainly affected the sensory portion of the nerves. Did this person have bilateral or unilateral damage?
I experienced so much neuropathy with my Lyme Disease. But I really believe more research is needed on the cause of all the facial issues, which are attributed to Lyme but I actually think they’re all from Bartonella.
I was diagnosed with Lyme & Babesiosis.
Treated my Babesia first and resolved it quickly. I realized which symptoms were actually from Babesia.
Treated my Lyme next.it took much longer to clear up the neuropathy & I’m left with crippling arthritis.
But there were stubborn symptoms that remained -for which I got a diagnosis of Bartonella. That included the occipital headaches, sinus pain & congestion, pain behind my eyes (especially the left eye), jaw pain , as well as other symptoms outside the head, such as foot pain which is often misdiagnosed as Plantar Fascitis.
Bartonella is very misunderstood, and I wish there were more studies that look at Lyme + Bart and dissect them. I think part of the problem is that the govt says they haven’t proved Bartonella can be transmitted by ticks. Although the evidence suggests strongly otherwise!
Correct
I wonder if IVIg would have been a possible remedy for at least alleviation of neurological symptoms as the author noted the following:
“One previous case report described the sural nerve from a patient with tertiary LD, and it showed axonal changes and the deposition of membrane attack complexes in the blood vessels of the perineurium and epineurium.20 The findings are intriguing, and they raise the possibility of an autoimmune response seen in various immune-mediated polyneuropathies. Since there is no demonstrable direct invasion of the peripheral nerves by the spirochete in LNB cases, an immune-mediated mechanism remains a viable underlying pathology in the pathogenesis of peripheral neuropathy in LD.”
Dr. Cameron, have you had experience is using IVIg in Lyme patients?
I have some patients who have benefited from IVIG. They have typically had to work with neurologists familiar with IVIG. I advise my patients to look a second time for a persistent infection before rushing to IVIG.
I was left with lyme arthritis for the rest of my life after taking antibiotics for 3 months straight, having already had gout, so now I can hardly walk, it’s in my hips,feet,knees, back, elbows, hands, every joint. I live in pain mostly from my bedroom. I currently am waiting for court with an SSI case. This has destroyed my life as it was. Drs all say just treat like regular arthritis, but I’m telling you it’s not regular arthritis. I feel horrible. And my legs just won’t work some days. It’s a feebleness, a weakness and pain..
I agree it’s not like “regular” arthritis and the other symptoms of weakness make it even worse. The good news is that if you continue with treatments (it can take a couple years in worse cases) the arthritis will go away. It took me almost 4 years on herbs alone to recover but I am now in remission and without symptoms including arthritis. You can take herbs with antibiotics so find a good Lyme literate Dr as you don’t want to be on antibiotics any longer than necessary. TreatLyme.net is a good resource for anything you might want to know about treating tickborn diseases. Hope you find some relief soon, it’s a horrible disease.
T Allen, I have it now and am so scared. I did 4 months of DOXY and I caught it very early, within a week, but had had nerve problems since my bite in May. I am off Doxy now but have trouble walking. I am taking banderol and samento…..could this be a herx or am I getting worse? So hard to tell……….need help.
I live in France and my lyme doc is baffled why they treat lyme with doxy because it does NOT go through the cell membrane to attack where the bacteria is living inside. This is why people are still sick afterward 🙁 Azythromysine does the job! I was so sick i could barely walk or think. Now i can go for walks and function “normally” with some fatigue of course.
Thank you I live in Poconos PA and was bitten 10 years ago by three ticks at same time. Started feeling tingling, twitching muscles for years. Have periferal neuropathy (idiopathic). I plan to go to talk to Dr Cameron as he is about 80-90 miles away.
I have some patients who have benefited from a change to a different antibiotic.
I have the same through all my body. So it’s not the first case..
What can I say but “me too”. I am now 65. I was bitten by a tick when I was 43. When I presented to my GP I had the bullseye rash on my leg and I was treated to two weeks of doxycycline. Needless to say I soon developed chronic Lyme Disease. When I developed numbness in the legs, loss of balance, and difficulty walking I went to a neurologist for an EMG. Diagnosis – Femoral Neuropathy. I was 47 and our Doctors at the time made no connection to Lyme Disease. My symptoms are now much worse and I now have severe Edema in both legs. A few years ago I was given intravenous antibiotic treatment in hospital but I fear that chronic Lyme Disease still prevails.
There are so many causes of neuropathy. Lyme disease happens to be one of them. Logigian and colleagues described Lyme neuropathy in 1990.
I first became sick in the nineties…I also was in my 40’s….I became very sick without a definitive cause and in 2010 was diagnosed with chronic lyme thru igG in California…had to quit working…had trouble physically and trouble with my memory…
I’m not as bad now 2023 but each day is different some days I’m still bedridden and just take one day at a time.
I am sorry to hear that
In 2015 I developed a strange rash accompanied with something of a strange flu. Vectorborne diseases are very little regarded in this country, knowledge scarce, as well as the health care system now economizing wherever it can. Lyme disease is like a non-disease. Doctors do not want to hear about it.
After some time I visited my doctor due to that the rash was spreading widely over my body as well as me developing heavy brain fog. My doctor did not understand what it was, and neither did I. A few years before this, I had reacted very much to being stung several times by deer keds/flies (Lipoptena cervi, carrying at Least Bartonella), and I thought perhaps this problem could be a sinister late reaction, as my immune system had overreacted a lot at the time. Looking at pictures on the internet for indication of this, I found pictures of rashes from the lyme bacteria instead. They were identical to mine. I therefore went back to the doctors office. Now I was suffering with sudden onset of heavy brain fog. It scared me. I insisted on testing, which was pretty scarce business. Lyme disease was actually established together with the well known co-infections. At that time I was feeling pretty bad, but the “experts” deemed me not sick enough for any treatment, as many of us experience.
I am 73 years old, fighting this completely on my own since 2015 with plant medicine and other stuff, now in the eighth year. In other words I have kept myself going!
As there was no help to get, I kissed allopathic medicine good bye almost for good. Taking cure after cure of antibiotics is really considered of no use for lyme anyway as the bacterias just go into hiding in different forms for a while by this. Also due to the fact that I observed how the lyme really do mimick all kinds of medical problems. One would pass after a while, another issue would take over. I figured that if any doctor would take me seriously, I would be havily medicated for all kinds of problems that would change places, or – I could just become considered the biggest hypochondriac alive.
The start for my own trials of healing was finding very useful information about how teasel root could alleviate brain fog. And it did. Very grateful. (Information here: https://www.flaatthjelp.net/urteoversikt/virksomme-urter-mot-borreliose/)
Since then – I have bought loads of books and plant medicine and information, while making my own tinctures and concoctions after endless hours of research on the internet. I have tried out many different diets, many strange remedies and I have logged most of it through the years so I could go back and see what worked, whenever I suffered from information overload as well as having flares or new symptoms. It is really like a full time job. At the same time, I am trying not to become my own illness. But I must admit, that when I began to feel terrible using my phone or being exposed to any emf, I was close to giving up for good. It felt like a nightmare when I realized that I was sensitive to all kinds of radiation. I know now, that we all are affected by it, but not all can feel it yet. But I did again what I always do – (best advice in the world) : doing what I can, with what I have – from where I am at: Ditched my smart phone, got rid of wi-fi at home – cabled my pc for internet – as well as reduce exposure to emf- sources everywhere as much as I could. Shielding my smart meter was very important. I always just have to recalibrate, and think again, using patience. Many of the excellent doctors and specialists I have read up on, state that exposure to emf actually hinders healing in general – also of lyme.
I have in addition worked up a very good intuition, I ask my body what it wants when in doubt – because this is really not just a mechanistic world view problem – it is very spiritual problem as well. My counter is full of bottles and boxes with all kinds of remedies, and it is a real job to know what to take – or not. Getting rid of the fear of what this shit can do to you, is the most important step. Fear is never a good fuel for solving problems.
The fact is that I am still here, after much work on my own – not without set backs and quite dramatic health turns – examples: Believeing I was dying from a heart attack in the night, legs being so bad I needed a walking stick, thinking that I a wheel chair would be the next step as well as getting MS medication, brain fog so heavy that I was sure of galloping Alzheimers and so on…. so far, none of it has happened. My legs still work.
Now this last year, I discovered strong indications of diabetes and neuropathy as well. I am actually pretty fit due to much physical activity all my life, but seeing that diabetes and neuropathy in legs, feet and hands were on the rise, and reading that allopathic medicine says there is not much to do about it – it was hard to not become scared. At first I thought only about lyme and neuropathy, but the more I studied and researched – I could see that diabetes 2 was now developing fast in my body. All indications were there. I was very bewildered by this, and wondered again whether I now must see a doctor about it, and throw in my towel at last. Like a miracle, I found this video when I researched neuropathy and lyme: https://www.youtube.com/user/KnowHowThingsWork/videos
It is about his guy with lyme who did a three week fast to get better. Fasting resets the body’s own healing abilities. I got very inspired by his good information, including him referring to good people I have trusted information from myself during my years. So I followed up and did 20 days of fasting on water and a bit of salt. The bacterias went really wild in my body, it was a miserable three weeks, but not that difficult. I just had to stay calm and wait it out, realizing that being hungry and starving was two different things. It helped a lot in general, but the neuropathy is still bothering me. But then, this man Xiren is about hirty years younger than myself 🙂 But I do not feel as sick just as often as I used to. So I keep up my regimes, and search the internet for new information on a continual basis. It is best to use a vpn and duck duck web browser, because what you can find will otherwise be screened by the “establishment’s” alghoritms because it is in their interest that we all go allopathic only. Try it out yourself and you will see. It is good to realize that plant medicine is actually the real medication worked up through thousands of years all over the world. It is the allopathic medicine that is synthetic – and therefore – the alternative medicine. Therefore, it is inspiring to have so much to choose from in plants and mushrooms (which are very immune modulating for us) – and so much to learn about. I read traditional medical papers sometimes, and can find information there that I can tranfer to plant medication. One such advice was the following: We need to attack vectorborne disease threefold: Eradication, detoxing from the bacterial deaths, and rebuilding our natural body functions so we can get so strong that the bacterias (or retroviruses) will calm down. The trick is to understand when we need to do what. Good luck to you all – know that you are included in my prayers, I know how difficult this is. Take care and be grateful for every victory, however small or transient. Focus on all that is good – any time any where.
Was diagnosed with a positive lyme test in 2015. did a series of different antibiotics for several months that included doxy and erythromycin-cant remember the others. couple months after that, had another lyme test and this time it ended up indeterminate because a negative borrelia result could not be established. three years later, started having numbness in both arms and my legs. went to see a neurologist and had tests done to confirm a damaged nerve plus was diagnosed with peripheral neuropathy along with lupus. vit b12 levels were low so started taking that which really helped. low levels of vit d needs to be checked too. lyme and antibiotics can wreck havoc on a persons stomach and i think that contributes to not being able to absorb nutrients as needed, hence low levels. eating cabbage, sauerkraut and juice helped my stomach. hope my experience helps someone out there. lyme is very serious stuff
Hi. I’m a New Zealander. My wife and I had a married daughter living in Sag Harbor (North Haven) Long Island. We traveled to visit her and our grandchildren frequently. Despite her caution re deer ticks (nightly inspections), in 2008 we returned to Christchurch, and I discovered a live tick attached to my inner thigh. Shortly after I experienced tingly prickly sensations in firstly my right foot, and eventually both feet. After several tests, I was diagnosed with idiopathic peripheral neuropathy. I’ve lived with the condition ever since, and never thought about Lyme until recently when my granddaughter (who was diagnosed with Lyme) has been suffering several related illnesses. I’ve used Gabapentin for 14 years until I recently reached the max dose of 12 tabs daily. I’ve now changed to Pregabalin. Finally, I’m 76, I’m clumsy on my feet (can’t walk in a straight line) and I’ve accepted that its a condition that I’ll have until I die.
Great question. One of many unanswered questions.
I have been having neurological symptoms since 5/23 after a 4 day backpacking trip in the Adirondacks. no EM, no obvious ticks on my person. I have been having whole body fasciculations, muscle spasms, and joint pain. My Lyme test came back inconclusive. I was given 21 days of Doxy, the symptoms subsided for 8 months, I was placed on an additional 7 days of doxy. Symptoms came back in March of this year. I have had NCS, EEG, EMG, Head/ spine MRI. They have r/o all major neuromuscular possibilities. On a whim, I asked for a CD8-CD57 test which was ‘LOW”. I have found that this occurs in neurologic Lyme. I live in Las Vegas and can not get a single ID physician to see me. Everyone states if my Lyme test is +/- or inconclusive, I do not have lyme and I do not need to be seen. When asked about how Doxy seemed to work initially (and for 8 months) and why I have a low CD8-CD57, they all respond ” I don’t know what the correlation is. I could use some help and potentially some medical tourism to rule this out.
I am sorry to hear you have been ill. I wish the Lyme disease and tests for co-infections were more reliable. I also wish a single 3 4o 4 week course of antibiotics would be more effective. I advise my patients with a negative or borderline test to rule out other illnesses as you have done. If my patient is still ill, I have patients who have done well with retreatment of Lyme disease or treatment for a tick-borne co-infection like Babesia.
Hi, I was diagnosed with late stage (chronic?) Lyme and Bart in 2020, along with reactivated EBV and mold. Still on treatment, but no antibiotics since 2022. I suffered a mild hip injury in Oct 2023, but it didn’t really disrupt my life so I didn’t see a doctor. Shortly after getting Covid in July 2024 I suddenly have a lot of intermittent nerve pain down my leg, especially deep in my thigh/hip area. Maybe the femoral nerve or piriformis muscle compressing sciatic nerve(?) Do you think it’s possible that Covid caused the Lyme/spirochetes to come out of hiding and affect the nerves in my thigh/hip area? I’ve heard spirochetes love scar tissue (from previous hip injury). If it’s possible, do you think I should talk to my LLMD about going on short-course antibiotic(s)? Thank you!
I have patients whose Lyme disease flareup from various illnesses including COVID but an not sure the cause
One of the many symptoms I experienced during the two months before the final diagnoses of Lyme/Babesiosis was terrible pain in my right piriformis muscle. It would hit me right after lying down to go to sleep. On a scale of 1 to 10, I would rate the pain as 11. Prior to that time, I had not experienced sciatic pain down my right leg after successful Chiropractic treatments thirty years before that.
At least10 or better years since I got bitten and got Lyme disease. Has layed dormant till spring of 2024. started in hands, pain, swelling, stiffness, like severe arthritis! Its very aggressive, within 2 months, I could hold nothing, no fist, swelling and stiffness is bad, with buckles getting spurs, all that arthritis does, but all within 2 months. Every joint now is effected now, 6 months since is started. no Dr around herd want to admit or treat me for Lyme disease. Everything I see you all go threw, it has to be that. I’m in central PA, any suggestions
I advise my patients to follow through with specialists to rule out other illnesses. I also urge patient I have seen to seek a second opinion as doctors differ in their treatment.
My mother passed away 16 years ago of untreated Lyme. They were loading her with pills for Alzheimer, but it did nothing. Just few weeks before she passed they learned that she had Lyme. Too late. From all her documents I found, she was diagnosed with Lyme 5 years before her death but never been treated. Myself I’ve been bitten by ticks several times, being on antibiotics at least once a year.
I have pains all over my body, joints, even muscles on arms, due to arthritis my knees are “caput” and was diagnosed with lower back spinal stenosis. I have no idea how far Lyme is still involved with my problems. I need help, but don’t know where to start. I am 81 years old and not too many doctors want to bothered because of my age, even many doctors simply don’t accept Medicare insurance. But I still want to believe on Golden age and want to get back to line dancing. Sincere greetings to all of you.