Lyme disease causes diaphragm paralysis, resulting in breathing problems


In a letter to the editor, entitled “Atypical presentation of Lyme disease,” Jarosińska and colleagues describe a unique case of a diaphragm paralysis caused by Lyme disease. [1]

According to the authors, diaphragm paralysis as a complication of Lyme disease was first reported in 1986. Since then, there have only been 4 cases involving bilateral paralysis of the diaphragm, which can cause breathing problems in patients.  “… the presented case will be the fifth described case of bilateral diaphragmatic paralysis in the course of probable Lyme neuroborreliosis.”

Patients with this condition experience weakness of the diaphragm and “have reduced breathing capabilities or are unable to control their voluntary breathing. They also have difficulty maintaining adequate gas exchange, as the lungs are not able to inhale and exhale outside air as efficiently.”²

Lyme disease causes breathing problems

A 64-year-old man exhibited symptoms of acute respiratory failure when lying on his back and complained of dyspnea, breathing difficult during sleep, and pain in the cervical spine, which had been ongoing for about one month.

“Upon admission, physical examination revealed tachypnea, a thoracic breathing pattern, and increased respiratory effort with the activation of accessory respiratory muscles, without any signs of an acute respiratory infection,” the authors state.

A cardiac exam revealed bilateral phrenic nerve palsy and the patient was transferred to the neurology department for further testing, which revealed no significant abnormalities.

Infectious Disease Testing

“The diagnostic process was broadened and serological analysis was carried out to test for a number of antibodies,” including those specific to Lyme disease, the authors state.

Test results were positive for Lyme disease. However, there was no history of a tick bite.

“Hence, the patient was diagnosed with bilateral phrenic nerve palsy in the course of probable Lyme neuroborreliosis,” the authors state.

The patient was treated with IV ceftriaxone, followed by oral doxycycline.

“During the hospitalization, partial clinical improvement was achieved and the patient was discharged home in a stable condition without any respiratory support.”

According to the authors, “palsy of the phrenic nerve in the course of [Lyme neuroborreliosis] is a rare and unique symptom.”

However, “it seems reasonable to consider serological diagnostics for Lyme disease in patients with diaphragmatic paralysis of undetermined etiology.”


  1. Jarosińska A, Pilśniak A, Cieśla-Fuławka A, Dziubak W, Siuda J, Holecki MT. Atypical presentation of Lyme disease. Arch Med Sci. 2024 Jan 18;20(1):344-347. doi: 10.5114/aoms/175494. PMID: 38414461; PMCID: PMC10895935.
  2. Columbia University, Department of Surgery.

6 Replies to "Lyme disease causes diaphragm paralysis, resulting in breathing problems"

  • Deborah Fleshman
    03/14/2024 (9:36 am)

    I have had RMSF and I have alpha gal syndrome . I’ve been diagnosed with Costochondritis and sleep apnea . Now I wonder if the RMSF has caused this . I was never treated for it and suffered for a very long time lost my vision for a period of time and would run intermittent 105 fevers . But this chest pressure never goes away . Have had my heart checked and lungs and they are fine . ( so they say ) but the pressure is still there … I was tested over 12 times for Lyme all negative . It took me 7.5 years to get a correct diagnoses of Aloha Gal syndrome and another 6 months for me to go back and look at actual testing for what I thought was a full Tickborne Disease panel … only to find out it was just for Lyme !!! Anyway they ruled everything out and gave me the costochronditis diagnoses . Is there a test to see about this diaphragm paralysis ?

    • Dr. Daniel Cameron
      03/15/2024 (6:58 am)

      I have Lyme disease patients who have evidence of a tick bite but never test positive for Lyme disease.

  • Lynn Cash
    03/11/2024 (9:56 am)

    After receiving 3 vaccinations surrounding 1995-96 LD clinical trial studies, I learned how far back my Lyme symptoms went. I went thru legal counsel for damages.. I went to NIH & stood before 33 gov. doctors & that vaccines results on our bodies was enough to take it off the market! But mid way through the case the pharmaceutical company SmithKlineBeecham was bought out by GlaxoSmithKline & the new owners had no vaccine records “they could find”. Its all about $$ folks. Just ask Dr.Donta retired chief of Infectious disease at BU Boston. Ive been living/struggling with these EXACT.. symptoms for decades! I could write a book.. but not without help anymore.. best to all who have been harmed by denial of LD & the epidemic it truly is 🙌

  • Pat Fowler
    03/11/2024 (6:50 am)

    This could be my problem. 4 years ago I put on 15# (same weight for 40 yrs) after being sick 20 yrs, Lyme diagnosis 11 years ago. Now 20 years ago I said it was like my stomach stopped making noise and working. Now 4 yrs ago my stomach muscles seem not to be working at all, and I’m bloated and it seems abnormal to inflate and get air. I seem to force the air inflation in the cavity.

    • Dr. Daniel Cameron
      03/11/2024 (7:53 am)

      There are so many causes for each condition. I share this article to include Lyme disease in the evaluation. BTW Lyme can also be a cause of GI issues as an autonomic symptom

    • Sylvia
      03/11/2024 (10:57 am)

      This sounds exactly like my story as well. My digestive tract seems to have slowed down to nearly no activity. I eat one meal a day and small healthy snacks for breakfast and dinner. Never a sound from my stomach. Have been sick for 16 years. Never had weight issues. But now have gained about 20# and eating the least I’ve ever eaten in my life. I have no energy but make myself keep moving throughout the day. No balance. Constant headaches and joint/spine pains. Can’t bare the sunlight and neck constantly hurts. Each day I feel sick. It’s a hard hard life. It’s why I live alone and will stay alone as others don’t understand and it wears me out to try to keep up or explain. Best wishes to you in this horrible journey.

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