Lyme Disease Neuropathy
Lyme disease neuropathy may not affect all those who develop Lyme disease after a bite from an infected tick but where it does occur it can have devastating consequences. Neurological manifestations of Lyme disease, along with cardiac problems, are indicative of disseminated Lyme disease, or stage II Lyme disease. These symptoms are unlikely to occur immediately after a tick bite but may arise in the months following infection, sometimes only appearing after six months or more as infection spreads and causes inflammation and damage to nervous system tissues.
In some cases a person may experience nervous system symptoms whilst erythema migrans is present in the early stages of Lyme disease, but these are likely to be restricted to symptoms affecting the localized area near the bite, or in the skin rather than in the central nervous system itself. The late development of neurological manifestations of Lyme disease often mean that the initial tick bite is overlooked as a potential cause of the symptoms, making misdiagnosis a huge problem for Lyme disease neuropathy.
Some of the signs of possible neurological involvement during Lyme disease progression include headaches, fatigue, fever, myalgia, stiff neck, or neck pain, nausea, balance problems, vomiting, arthralgia, and photophobia. Patients may also experience Bell’s palsy, or other problems with nerves innervating the face or other parts of the body. In the majority of cases there is a triad of neurological symptoms that present with cases of Lyme neuroborreliosis consisting of lymphocytic meningitis, cranial and peripheral neuropathies, and radiculopathies. These are collectively referred to as Banwarth’s syndrome and may be seen in around 15% of Lyme disease patients even where initial symptoms such as erythema migrans were absent.
Neurological complications of Lyme disease are thought to be more common in patients infected in Europe due to the genetic polymorphisms of the Borrelia bacteria responsible for the infection there in contrast to North America.
Neuropathy and Myelopathy
Lyme disease neuropathy is a term limited to the nerve pain and the effects of specific nerve involvement rather than the myriad neurological issues that are also associated with Lyme disease, such as cognitive dysfunction, memory problems, and even schizophrenia-like illness and bipolar disorder. Nerve dysfunction results in problems with innervation and sensation and peripheral neuropathy is where the nerves involved are those sending and receiving nerve signal transmissions through the peripheral nervous system as opposed to the central nervous system. Myelopathy with Lyme disease is thought to be a much rarer occurrence than Lyme disease neuropathy affecting the toes, fingers, hands, and peripheral organs and body systems.
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