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Neuroborreliosis is a manifestation of Lyme disease in the central nervous system (brain and spinal cord). It often develops months or years after the initial infection. Its symptoms are comparable to those of meningoradiculitis, as well as the loss of cranial nerves such as paresis of the facial nerve and psychiatric abnormalities. Patients’ complaints also include headaches, chronic fatigue, visual disturbances, sensitivity to light and noise, and mood swings. 

50% of those affected by a tick bite do not develop erythema migrans. Since the bite is often overlooked and/or painless, the disease can often progress unhindered.  

Symptoms and course

Doctors distinguish between acute and chronic neuroborreliosis. The latter is when the symptoms last longer than six months.

Acute neuroborreliosis

Neuroborreliosis is acute in 90 – 95% of all cases. The first symptoms appear within weeks of the tick bite, in which the bacterium Borrelia burgdorferi was transmitted. The result is a ‘non-sided’ inflammation of the meninges and nerve roots of the spinal cord (meningo-polyradiculitis). Those affected suffer from excruciating pain (especially at night) in the area of the nerve roots/paths. It can also lead to paraesthesia and paralysis. 

Chronic neuroborreliosis

In 5 to 10% of patients, neurological symptoms develop gradually over several months or years. In most cases, there is a chronic progressive inflammation of the brain and spinal cord (encephalomyelitis). Those affected often have no pain at all, but suffer from gait and movement disorders as well as problems emptying their bladder.

Other possible symptoms at this stage include speech and language disorders, hearing loss and coordination disorders and, in rare cases, epilepsy or an organic psychosyndrome.

Diagnosis of neuroborreliosis

The doctor will make a clinical diagnosis to determine whether a patient has neuroborreliosis; in addition, some laboratory tests will also be carried out. Blood and cerebrospinal fluid can also be tested for specific antibodies that fight Borrelia bacteria. 

 Treatment of neuroborreliosis?

Antibiotics are used to treat neuroborreliosis, as they eliminate Borrelia. The duration of the therapy depends on the stage of the disease. The dosage must be sufficiently high and long enough to kill all bacteria.