Lyme Disease as a Reversible Cause of Chronic Illness
Can Lyme disease be a reversible cause of chronic illness in some patients? A growing body of research suggests that it can.
Studies have documented that Lyme disease may lead to persistent or chronic symptoms, including Lyme encephalopathy, Lyme neuropathy, chronic neurologic Lyme disease, and neuropsychiatric Lyme disease.5-7
When clinicians maintain a high index of suspicion for Lyme disease, they may identify a potentially reversible cause of chronic illness that would otherwise be missed.
Below are examples drawn from dozens of published papers and case reports highlighted in the Inside Lyme Blog. These reports describe situations where Lyme disease was identified as a reversible or treatable cause of another chronic medical condition.8
Brain Diseases and Neurological Disorders
- 80-year-old with Lyme encephalopathy instead of dementia
- Chronic post-concussion syndrome symptoms due to Lyme disease
- POTS patients with brain fog have neurocognitive deficits
- When it looks like a brain tumor but is Lyme disease
- Untreated Lyme disease triggers a stroke in a 9-year-old boy
- Lyme disease and stroke
- Child with Lyme disease presenting as pseudotumor cerebri
- Chronic inflammatory demyelinating polyneuropathy (CIDP) resolved with antibiotics
- Lyme meningitis manifesting as parkinsonism
- Seizures and altered mental status after a tick bite
- Dementia and normal pressure hydrocephalus
- Cognitive issues following a stroke due to Lyme disease
- Stroke as a manifestation of Lyme disease
- Lyme disease causes “false brain tumor” in a child
Cardiac Disease
- Lyme carditis cases with varied presentations
- Lyme carditis presenting as atrial fibrillation
- Lyme disease causing mitral valve endocarditis
- Lyme endocarditis
- Another cardiac manifestation: Lyme myocarditis
- When Lyme disease mimics a heart attack
Autonomic Disorders
- POTS and Lyme disease
- Subacute transverse myelitis
- Femoral neuropathy
- Autonomic dysfunction and small fiber neuropathy
- Acute transverse myelitis
Psychiatric Illnesses
- Lyme disease presenting as depression
- Somatic symptoms mistaken for depression in early Lyme disease
- Oppositional behavior in children
- Obsessive-compulsive symptoms
- Depression in Lyme disease patients
- Suicidal behaviors
Clinical Insight
In my clinical practice, patients with chronic illness are sometimes found to have an underlying infectious trigger such as Lyme disease. Because Lyme disease can mimic neurological, psychiatric, cardiac, and autoimmune conditions, the diagnosis may be missed unless clinicians carefully review exposure history, symptoms, and diagnostic testing.
Recognizing Lyme disease as a potential contributor to chronic illness can be important, as treatment may improve symptoms for some patients.
Learn more about the wide range of Lyme disease presentations in our Lyme disease symptoms guide and the challenges of Lyme disease testing and diagnosis.
Conclusion: Lyme disease can present with a wide range of clinical features and may mimic many chronic medical conditions. Diagnosis requires careful clinical evaluation, neurologic examination, and appropriate laboratory testing. When Lyme disease is identified as the underlying cause, treatment may improve or reverse symptoms in some patients.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I have a little more confidence that I may be treatable. For years I have been begging for help, explaining that I get worse every month. I’ve been treated with IV antibiotics for over 10.5 months. Past record holder for Bartonella. Recently diagnosed with autonomic dysfunction and POTS. I’m disabled because of tachycardia and BP ranges 64/35 to lower 90’s / lower 60’s. HR ranged 49 -149 during bed rest wearing halter monitor. I’m hoping to be able to give my ID a suggested direction for more investigation and same with the special cardiologist that has been trying to get my BP to a higher level so I can at least take care of myself. Sincere thanks.
I have included cardiologists in Lyme disease patients with POTS. You never mentioned treatment for the tick-borne pathogen Babesia that can also lead to autonomic dysfunction.