Can a Tick Bite Cause Guillain-Barré Syndrome?
Tick-borne infections may affect the nervous system
Weakness and numbness deserve prompt attention
Early recognition may improve outcomes
The study entitled “Case of ehrlichiosis induced Guillain-Barre Syndrome in a 71-year-old female” described a woman who initially appeared to have a tick-borne infection but later developed Guillain-Barré syndrome (GBS).
Can a tick bite cause Guillain-Barré syndrome? Although uncommon, infections transmitted by ticks—including Ehrlichia, Lyme disease, and other pathogens—have been associated with neurologic complications that may resemble or trigger Guillain-Barré syndrome.
The woman’s symptoms developed over three weeks and included generalized weakness, dizziness, visual changes, chills, fever, neck pain, and abdominal pain.
After presenting to the hospital, she was diagnosed with Ehrlichia based on a low platelet count, elevated liver function tests, an insect bite history, positive PCR testing, and the absence of another illness source.
She was treated with doxycycline and initially improved.
Neurologic Symptoms Progressed After Treatment
Approximately one week later, she returned to the hospital with worsening symptoms.
The authors reported worsening numbness and loss of reflexes involving the lower extremities.
She developed gait instability requiring a walker, tingling in her feet, and difficulty urinating requiring catheterization.
Clinicians ultimately diagnosed acute inflammatory demyelinating polyneuropathy—the most common form of Guillain-Barré syndrome.
The patient improved significantly following IVIG treatment and rehabilitation.
Can Ehrlichia Cause Guillain-Barré Syndrome?
Ehrlichiosis is not commonly recognized as a cause of Guillain-Barré syndrome.
However, the authors noted that proposed mechanisms may resemble other infectious triggers including Lyme disease and Campylobacter jejuni.
The authors emphasized the importance of maintaining a broad differential diagnosis when neurologic symptoms progress despite initial improvement.
There was no evidence of Lyme disease, Babesia, Heartland virus, Bourbon virus, or other known tick-borne infections in this patient.
What Is Guillain-Barré Syndrome?
Guillain-Barré syndrome (GBS) is an acute autoimmune demyelinating polyradiculoneuropathy characterized by rapidly progressive weakness.
Symptoms may include:
- Progressive weakness
- Numbness or tingling
- Difficulty walking
- Loss of reflexes
- Balance problems
- Autonomic dysfunction
- Urinary symptoms
Severe cases may affect respiratory muscles and become life threatening.
Learn more about neurologic Lyme disease.
Other Tick-Borne Infections Can Mimic Serious Illness
The article also reviewed Bourbon virus, a newly recognized tick-borne illness associated with severe disease.
One reported case involved a 50-year-old man from eastern Kentucky who developed fever, rash, low blood counts, gastrointestinal symptoms, and progressive multiorgan failure after multiple tick bites.
His illness did not improve despite tetracycline treatment and was later linked to Bourbon virus.
These reports highlight the complexity of evaluating severe illness after insect or tick exposure.
Treatment for Guillain-Barré Syndrome
Treatment commonly includes intravenous immunoglobulin (IVIG) or plasma exchange.
Steroids generally have not demonstrated meaningful benefit.
Recovery varies, but many patients regain independent walking ability.
Early recognition and supportive care remain important.
Frequently Asked Questions
Can a tick bite cause Guillain-Barré syndrome?
Rarely. Tick-borne infections including Ehrlichia and Lyme disease have been linked to neurologic complications that may contribute to Guillain-Barré syndrome.
Can Lyme disease cause Guillain-Barré syndrome?
Lyme disease has been associated with neurologic complications, including rare cases resembling or triggering Guillain-Barré syndrome.
What symptoms suggest Guillain-Barré syndrome?
Progressive weakness, numbness, difficulty walking, loss of reflexes, and urinary symptoms may raise concern.
Can Ehrlichia affect the nervous system?
Yes. Ehrlichia infections occasionally involve neurologic complications.
When should neurologic symptoms after a tick bite be evaluated?
Progressive weakness, balance problems, or numbness after a tick bite deserve prompt medical attention.
Clinical Takeaway
Neurologic symptoms after a tick bite deserve careful evaluation, particularly when weakness, numbness, or gait problems worsen over time.
Although uncommon, infections such as Ehrlichia and Lyme disease may trigger immune-mediated neurologic complications.
A broad differential diagnosis remains important when neurologic symptoms evolve after suspected tick-borne illness.
Related Articles
These related articles explore neurologic complications, coinfections, and unusual symptoms linked to tick-borne illness.
Delayed Lyme Disease Diagnosis
Lyme Coinfections
Lyme Disease Symptoms Guide
Autonomic Dysfunction in Lyme Disease
Unusual Symptoms of Lyme Disease
References
- Malhis JR, Mahmoud A, Belote A, Ebers A. Case of ehrlichiosis induced Guillain-Barre Syndrome in a 71-year-old female. IDCases. 2021;26:e01301.
- Kosoy OI, Lambert AJ, Hawkinson DJ, et al. Novel thogotovirus associated with febrile illness and death, United States, 2014. Emerg Infect Dis. 2015;21(5):760–764.
- Heartland and Bourbon Virus Disease. Centers for Disease Control and Prevention. Accessed 5/30/25.
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 personally seen this in someone post-vaccine.
It seems as though many are experiencing extremely similar symptoms after having Lyme, Covid and post vaccine. Long Covid, Chronic Lyme and Post vaccine injury are almost symptomatically identical.
What is the common denominator here?
In the mid-70s, I had a neighbor contract GBS associated with a viral infection. In the early 80s, as my undiagnosed condition spread throughout my body, I noted how similar it was to her description of the GBS onset…moving from extremities towards the trunk. It took 37 years to diagnose Lyme/Bartonella with multi-viral reactivation. I still remember how each new flare-up would introduce “whatever it was” to a new muscle/joint complex, then die down to embers until new stress or source of fatigue would start the process in a new area. It took 8 years to fully envelop the musculoskeletal system, then was present but subdued until 2017 when multi stressors led to an immune collapse. Multiantibiotic treatment plus several herbals are showing progress, but this latest flare damaged brain function more noticeably. Someday someone will find the common links.
I was Lymes- sick in June of 2020 while in Maine for the summer. I developed big circular rashes all over my body not bull-eyes. I had a fever as high as 103 up and down. This lasted about a week, my head ached, I vomited when my fever was the highest. I had body violently shaking with chills. When the rash hadn’t gone away after 2 weeks I went to a walk-in. Covid was new then and we tried to stay away from places like that. I’d had a test while I was sick which was negative for Cobid. The PA at the clinic took a look at my rashes asked me where I hurt that was new, I told her my knees, my neck. She diagnosed me with Lymes sickness and prescribed 3 weeks of Doxycycline. By late July early August I was still feeling fatigued more than my normal and just ached all over. We found a NP who was very LL because she’d had it herself. She became our most caring practitioner. Without all the details in between, I was getting worse we had headed back to Florida for the winter. I’m getting more fatigued and had very little energy to walk and it was becoming more difficult. I had some very bad falls. I saw a quack in Florida stating he was LL but to a Lymie it doesn’t take long to realize when someone doesn’t understand Lymes and co-infection. My practioner in Maine had ordered Igenix Lymes testing in August and my results were: Positive for Borreliosis, Burgdorferi, Babesiosis and Mycoplasma. I gradually lost feeling in my hands and feet and my arms and legs. By January 2021 I was in bed. In April I made contact with the practitioner in Maine and begged her to please help me long distance. Seeing the lyme specialist in Florida had been a total waste of time . With her help and the supplements and tinctures made by an herbalist in Maine and a Compounding Pharmacy here in Florida for LDN, I had neck surgery on September 29th to fuse C-5 & 6, with a basket and screws around it. I have been in-patient re-hab following my surgery for 6weeks. Now I’m home I’ve regained feeling in my limbs and walking with help for short distances. I’m actually going to walk again.
Ik hoop dat dit vertaald kan worden. Ik vertelde het eerder. In 2016 had ik GBS, alle ledematen verlamd, inclusief nek en de ademhaling. Grove tremor/uitschieters aan armen en fijne over het hele lichaam. De volgende dag had ik een klauwhand en een slappe arm, 2 klapvoeten, heel zwakke benen, romp, armen, nek en slikstoornissen. Ademhaling was nog steeds slecht en daarbij witte tenen en vingers. Die avond ervoor, acuut verlamming, waren mijn vingers halfblauw en kon bijna niet meer praten. Dr. Daniël heeft gelijk, het is een gevolg van diverse oorzaken en geen auto immuunziekte. Het kan net als bij Covid, auto immuun reageren, net als bij long Covid. Ik ben na 4 maanden langzaam hersteld.
I told you before. In 2016 I had GBS, paralyzed all limbs, including neck and breathing. Coarse tremor/outliers on arms and fine all over body. The next day I had a claw hand and a limp arm, 2 foot drop, very weak legs, trunk, arms, neck and swallowing difficulties. Breathing was still bad with white toes and fingers. That night before, acutely paralyzed, my fingers were half blue and could barely speak. dr. Daniel is right, it is a result of various causes and not an autoimmune disease. It can react autoimmune, just like with Covid, just like with lung Covid. I have slowly recovered after 4 months. [translated with google]
BTDT. Tick exposure in New York, Vermont in 1995. Lyme and associated TBDs followed, misdiagnosed GBS, CIDP.
My insurer’s PCP, ID and Neuro gatekeepers followed IDSA Lyme Dx and TMT guidelines. I almost died. Had to self pay for IGENIX tests, IV antibiotics. Much improved now but still disabled, and battling multiple NHL cancers, jaw pain. I asked two insurers to reimburse my out of pocket costs. Won two court cases, lost 2 — the last in 9th Circ Appeals court. Some hate light and love darkness.
I was diagnosed with Guillain-Barre syndrome in March of 2023 with paralysis from waste down. Months later and 3 hospitals later my neurologist tested me foe epison barr and lyme both positive.
It’s been a horrible experience and I’m still recovering. It’s hard to work. Walk my dogs. Daily tasks. Plus I went through both hurricanes in florida and suffered through this living in my truck w my 2 dogs.
I have patients with more than one condition. I have patients who are still ill after a neurologic condition who also have Lyme symptoms. Here is a published article where they treated both. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249767/
Diagnosis lyme disease after having been found unresponsive in hotel and woke out of 5 day coma only to become paralyzed 7 days later. It has not even been a year yet.