Lyme neuroborreliosis mimics Guillain-Barré Syndrome


Guillain-Barré Syndrome (GBS) is an autoimmune disorder which involves your immune system mistakenly attacking the peripheral nerves outside of the brain and spinal cord. It typically presents with weakness and/or tingling sensations in the legs, which can progress and spread to the arms and upper body.

In this case report, the authors describe a 33-year-old man with Lyme neuroborreliosis, who was initially diagnosed with Guillain-Barré Syndrome based on his clinical, radiographic and neurodiagnostic test results.

Guillain-Barré Syndrome “can range from a very mild case with brief weakness to nearly devastating paralysis, leaving you unable to breathe independently.”1

GBS typically develops after a person has had an infection. “In up to 70% of people who’ve had GBS, their symptoms started within one to six weeks of an illness.”2  It can also be triggered by vaccines or surgery.

In their article, “Neuroborreliosis presenting as Guillain-Barré syndrome,” Farr et al. describe a case of neuroborreliosis (neurologic Lyme disease) where clinical, radiographic and neurodiagnostic findings mimicked GBS.3

A 33-year-old man presented to the emergency department with progressive weakness and numbness in both hands and feet following an upper respiratory tract infection and an abdominal rash.

“The patient reported that his symptoms started one week ago as a “tingling sensation” in his hands and feet with perioral numbness along with a concurrent fever, nonproductive cough, and a “blotchy” abdominal rash,” the authors state.

A physical exam also revealed bilateral facial palsy, as well as hyporeflexia at his knees and ankles with downgoing plantar responses. And, he had a decreased sensation to light touch below the elbows and up to his knees.

Furthermore, findings from an MRI and needle electromyography (EMG) suggested the patient had Guillain-Barré syndrome, also known as acute inflammatory demyelinating polyneuropathy.

“Given the clinical, radiographic, and neurodiagnostic concern for GBS, the patient was started on a five-day course of intravenous immunoglobulin (IVIG),” Farr states.

However, the man did not respond to treatment. And, his condition worsened. Respiratory complications required a tracheostomy.

Since he did not respond to IVIG treatment, the patient was tested for Lyme disease, as he reported frequently being in wooded areas and had an abdominal rash, along with a fever and cough prior to developing GBS-like symptoms.

Western blot testing was positive for Lyme disease.

The man’s symptoms improved significantly after a 4-week course of treatment with IV ceftriaxone and doxycycline.

“Eight months after the start of symptoms, the patient had recovered significantly,” the authors state.


  1. National Institute of Neurologic Disorders and Stroke website.
  2. Cleveland Clinic website.
  3. Farr J, Bittar J. Neuroborreliosis Presenting as Guillain-Barré Syndrome. Cureus. 2023 Jul 23;15(7):e42322. doi: 10.7759/cureus.42322. PMID: 37614265; PMCID: PMC10443435.

5 Replies to "Lyme neuroborreliosis mimics Guillain-Barré Syndrome"

  • wharfrat111
    10/08/2023 (10:03 pm)

    TBRF/RMSF does more than just mimic Gullian-Barre’, getting a COVID Booster shot caused my GD1b antibodies to be activated, while simultaneously IFA positive for RMSF during serial blood testing over the course of 4 COVID shots.

    • Dr. Daniel Cameron
      10/11/2023 (7:48 am)

      GD1b antibodies can be activated by a number of conditions

      • Kelly
        11/10/2023 (10:48 am)

        My husband has tested positive for several lyme, co-infections, and viruses – and now suffering from MND mimicking symptoms. Neurologists completely dismissed idea of Lyme and we lost many months, now on an antibiotic protocol but not confident and would like another opinion. Is this an area you are familiar with to treat?

        • Dr. Daniel Cameron
          11/10/2023 (5:13 pm)

          I don’t have many patients with motor neurone disease (MND). They usually stay with neurology. I have had to treat some of them for a persistent tick borne infection to rule out any underlying factors but the results are mixed. I have patients with both Lyme and MND whose Lyme disease symptoms improve which helps their quality of life.

  • Colleen
    10/07/2023 (6:11 am)

    I remember only having a rash like this one other time and it was the same summer as the worst “summer flu” ever.
    This time, the rash is also on the smalls of my back, and small raised bumps itching between left ring finger and index with one spot appearing randomly in other areas that disappear soon after starting.
    All started as an allergy type rash white raised a bit like a bug bites but turn red and to a burning itch such as a nettle burn. The smalls of my back appeared lightly on one side the first day increasing on day 2 and 3 while the stomach rash seems to be subsiding. The tick was negative this time for Lyme but positive for babesia odocoilei. My feet have increased burning, I have developed a slight cough over the day prior to the rash and the next 2 days, sore nose cartridge only on one nostril, cramping of the left hand periodically, bruises on both left and right side hip and outer thy areas along with calf area but all bruises look different.
    I was very lethargic 3 days before the rash appeared. The day it appeared, I felt fine otherwise. On the second day, I woke with a sore throat so I tested for covid, which was negative.
    After reading this article it reminded me that that first summer flu and the belly rash was the beginning of Ms like symptoms that turned my right side inward.
    Since, I have suffered several emergency visits for various issues that do not run in the family.
    Heart, stroke, ostioma, adrenal mass, thyroid and parathyroid masses, lung mass, kidney stones as large as 7 mm, with small masses, a tortioned ovarian cyst as large as a soda bottle the nurse described. As well as neurological and physical issues, now also having severe osteoporosis.
    Tick-borne diseases are still not looked at in the same way even covid is. The lucky ones get to see doctors and professionals such as in this story, that will go beyond and find root causes to treat with iv.
    Only once since my first “summer flu” I felt normal for 3 days and it was after an er visit that I received and iv treatment of an antibiotic that I can only remember started with a c.
    For 3 days, in over 15 yrs, I had no pain, no numbness, no mental fog, and could even run!

    Keep helping patients for as long as you can and longer…

Join the Lyme Conversation
(Note: comments are moderated. You will see your comment after it has been reviewed.)

Some html is OK