Full body numbness and tingling due to Lyme disease
In their article “Lyme Disease Presenting With Interesting Neurological Features of Weakness and Hyporeflexia: A Case Report,” Semy and colleagues describe the unique case of a young woman with Lyme disease who exhibited solely neurologic features of numbness and tingling throughout her body. 
The 25-year-old female developed numbness and tingling throughout her torso, which later spread to her entire body. She presented to a neurology clinic with complaints of numbness and tingling that had been ongoing for the past 4 weeks.
She did not recall a rash or tick bite and had not recently travelled.
The woman did not exhibit any of the typical symptoms seen with Lyme disease such as “arthralgia, fever, rash, or regional lymphadenopathy but in fact exhibited decreased reflexes, numbness, and tingling particularly near the hypogastric region making it distinct from the classical presentation,” the authors wrote.
The numbness and tingling began on the right side of her stomach and radiated to her back and later spread to her entire body. “The tingling was not associated with any burning or pins and needle sensation,” the authors point out.
The woman was prescribed steroids and an albuterol inhaler. But her symptoms did not improve.
“She especially became alarmed when she could not hold her toddler anymore and ended up dropping the child secondary to her numbness and tingling.”
Motor examination revealed that the patient had “decreased tone more significant in the upper limbs (3/5) than in the lower limbs (4/5) along with hyporeflexia in the biceps, triceps, patellar, and Achilles,” the authors wrote.
A lumbar puncture revealed elevated protein concentration (148 mg/dl; normal: 15-60 mg/dl).
The Western blot test for Lyme disease was positive, and the woman was prescribed IV ceftriaxone for 3 days before transitioning to oral doxycycline.
“At the time of discharge, the patient was able to move all extremities spontaneously and ambulate with a normal gait,” the authors wrote. At her follow-up visit, she exhibited only minimal residuary weakness.
- “Physicians need to be aware of the non-pathognomonic timeline of the disease at presentation since the clinical presentation of the disease can differ significantly from one individual to another.”
- Semy M, Lee-Kwen P, Semy S (August 10, 2023) Lyme Disease Presenting With Interesting Neurological Features of Weakness and Hyporeflexia: A Case Report. Cureus 15(8): e43296. doi:10.7759/cureus.43296