Lyme disease leads to muscle weakness of the leg and constipation


In their article, “Atypical Acute Neuroborreliosis With Leg Paresis and Constipation,” Ahrend and colleagues describe a case of Lyme disease presenting with neurological and autonomic manifestations in an elderly man. [1]

An 80-year-old man, later diagnosed with Lyme disease, was admitted to the hospital with left leg paresis [muscle weakness], along with pain and sensory disturbances in his left abdomen. He also had a rash on his left lower abdomen, severe abdominal pain and constipation. The symptoms had been ongoing for 4-5 weeks.

The patient had visited three other medical centers for evaluation of his abdominal pain. However, a colonoscopy and CT scan of the abdomen did not explain the severity of the patient’s symptoms.

The rash manifest as a “patchy, pruritic redness with pustules, which was particularly prominent on the left flank and abdomen,” the authors state.

Testing for Lyme disease revealed Borrelia-specific IgM and IgG antibodies, consistent with the symptomatology of neuroborreliosis.

“Finally, a diagnosis of [Lyme disease] was made, which initially manifested itself with autonomic symptoms (constipation) and severe abdominal pain, accompanied by a skin rash” and muscle weakness in his left leg that appeared later on, the authors state.

“The patient’s constipation is likely due to the autonomic involvement of the disease.”

The rash, characterized as a flat, itchy redness with pustules, was atypical for Lyme disease, the authors point out.

“… serological tests were finally conclusive for Lyme borreliosis, so that the abdominal pain and [constipation] were evaluated as autonomic, and the leg paresis as neurological involvement of neuroborreliosis.”

The patient’s symptoms resolved completely following a 21-day course of doxycycline.

After treatment for Lyme disease, the patient’s muscle weakness disappeared, as did his intestinal symptoms. And, he was able to “resume his home exercise program within two months and since then he has been on the same physical level as before,” the authors state.

  1. Ahrend H, Fibbe C, Jasper D, Ahrend A, Woelfel M, Layer P, Rosien U, Stope MB. Atypical Acute Neuroborreliosis With Leg Paresis and Constipation. In Vivo. 2024 Mar-Apr;38(2):940-943. doi: 10.21873/invivo.13523. PMID: 38418126; PMCID: PMC10905454.

9 Replies to "Lyme disease leads to muscle weakness of the leg and constipation"

  • Jessica
    03/19/2024 (7:52 pm)

    I had Lyme disease as a young teen and developed strange neurological symptoms over the next two decades, such as a drop foot and upper motor neuron signs. I have no idea if Lyme was the cause, and neurologists don’t know either. I haven’t seen a lot of research on the incidence of Lyme and upper motor neuron symptoms.

  • Irene
    03/18/2024 (10:33 am)

    I had Lyme disease in July of 2022. I was treated with doxycycline for 14 days.i had extreme pain in both legs when I was first infected. But now ,almost 2 years later I legs still ache. Not as bad as when I was diagnosed. I also have insomnia since the Lyme disease diagnosis. Trying to find a Dr who believes me is impoi.

    • Dr. Daniel Cameron
      03/18/2024 (11:27 am)

      You are not alone

      • Laurie
        04/11/2024 (8:39 am)

        Yes, we are alone. Because no one knows how to treat and diagnose advanced Lyme w/o the drugs almost killing us. . I was initially treated by Dr.Burrascano who helped me the first time and we know why he had to stop practicing. Criminal and have lost all hope.

  • J Gan.
    03/18/2024 (5:35 am)

    Dr. Cameron, you may want to suggest to Lyme patients with muscle weakness that they begin taking the supplement Urolithin A. It is an anti aging “post biotic” or stomach metabolite. There are studies that back up it’s efficacy, in this exact space.

    • Annalisa
      03/18/2024 (6:51 am)

      I have had Lyme since 2011. One of my biggest complaints over the years has been leg muscle weakness. Have you had that also?

      • Tania
        03/18/2024 (9:38 pm)

        So many people don’t believe when you have symptoms. To them, Lyme Disease has an easy fix with a pill for 14 days.
        Back in Spring of 2016, I suddenly was battling flu-like symptoms, but so much worse. The arthritis pain in my hands so severe I could only close them part way, both of my legs hurt to the point that I was crying, headaches, every muscle was on fire effecting nerves felt like I never knew was humanly possible. I had several unexplained patches of a red rash. After a week of suffering, I finally was driven to my doctor. At that single visit, blood was drawn to check for Lyme. It came back positive. Put on doxy pills for 2 weeks. Within that time, 3 bullseye circles had shown up on my inner thighs. Never knew I was infected.
        I spent months trying to walk on both weak legs, my arms lost strength, and my brain fog had taken over. I had even gone to an Infectious Disease Doctor in Pittsburgh/Monroeville. He told me nothing more could be done. It was like getting slapped with a death sentence.
        I was 52 yrs old back then, healthy and strong and enjoyed gardening. Now I can only shop holding onto a cart or walking short distances. Gardening is no Ionger possible. I am technically disabled and depressed. My grandkids keep me going.
        So sorry about the long reply, but this was the first I had ever told strangers of my battle with the disease.
        It can be crippling as I found out.

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