Problems With Driving in Lyme Disease

Driving is something most people stop thinking about once they’ve done it long enough. But problems with driving in Lyme disease can be an early functional sign of neurologic involvement, even before routine tests reveal abnormalities. It becomes automatic—hands know the wheel, eyes scan the road, the mind drifts just enough to make the trip tolerable. That was the case for one of my patients, who had driven the same route to work for more than 15 years without difficulty.

Then, without warning, driving became hard. What initially seemed like anxiety or fatigue turned out to be something far more neurologic.

Difficulty driving can be an early functional clue to neurologic Lyme disease, even when routine tests are unrevealing.

At first, the change was subtle. The road felt unfamiliar, even though nothing had changed. He found himself needing to concentrate in ways he never had before. Traffic felt overwhelming. He became anxious just thinking about getting behind the wheel. What once had been muscle memory became mentally exhausting.

Over time, the symptoms worsened. He described feeling as though he were “on autopilot,” but without awareness or clarity. Short drives left him fatigued. His joints ached. His arms and legs sometimes felt heavy or numb. Even sitting in the driver’s seat became uncomfortable.

“I don’t feel right,” he told his wife. “Even driving feels wrong now.”

Lyme disease can affect the nervous system, disrupting the very functions driving depends on—attention, sensory processing, reaction time, and physical comfort. In patients with neurologic Lyme disease, driving problems are often one of the first functional tasks to deteriorate, long before abnormalities appear on routine testing.

In his case, driving triggered sensory overload. Headlights felt too bright. The movement of surrounding cars felt chaotic. Ordinary road noise became irritating and distracting. Patients often describe this as “too much input”—the brain struggling to filter and prioritize sensory information. When that filtering breaks down, even routine tasks can provoke fatigue, anxiety, or panic.

Like many patients with neurologic Lyme disease, he saw multiple specialists. He underwent blood tests, imaging, and neurologic evaluations. Yet nothing clearly explained why such a basic, familiar task had become so difficult.

Standard Lyme testing has limitations, particularly in later-stage disease. False negatives occur, and clinicians do not always connect cognitive strain, sensory hypersensitivity, and functional problems—like difficulty driving—to a tick-borne illness.

Eventually, further evaluation revealed Lyme disease as the unifying diagnosis. Suddenly, the pieces fit together: the brain fog, the sensory overload, the physical discomfort, and the loss of confidence behind the wheel.

Treatment began, along with evaluation for common co-infections such as Babesia and Bartonella, which can complicate neurologic symptoms. Improvement wasn’t instant, but it was noticeable. Over the following weeks, the fog lifted. His energy returned. Driving became tolerable again—then routine.

Today, he drives to work without hesitation.

This case is a reminder that Lyme disease doesn’t always announce itself with a rash or flu-like illness. It can masquerade as anxiety, fatigue, neuropathy, cognitive slowdown, or sensory processing difficulties. In this patient, the red flag wasn’t pain alone—it was difficulty driving, a complex task that exposed deeper neurologic dysfunction.

Functional changes like difficulty driving may precede objective neurologic findings and deserve careful clinical attention.

When driving becomes cognitively or physically difficult, patient safety—not just symptom relief—becomes part of the clinical picture.

If you’re struggling with brain fog, sensory overload, dizziness, or discomfort while driving—or if you’re a clinician evaluating someone with these complaints—Lyme disease deserves consideration, especially in endemic areas. When the diagnosis is made, the trajectory can change.

Sometimes the first sign something is wrong isn’t dramatic.
It’s simply realizing that a familiar road no longer feels familiar at all.