Lyme Disease Neuropathy

Lyme disease is an inflammatory disease that rapidly progresses. Transmitted by the bite of an infected deer tick, Lyme disease is most common in the Northeast section of the United States. However, the disease has also appeared in the upper East coast, in the upper Midwest, and along the coasts of northern California and Oregon.

Signs of Lyme disease include skin rash and painful inflammation of joints (particularly the knees), accompanied by flu-like symptoms. The symptoms of Lyme disease increase in severity as the disease spreads though the body.

476000

Lyme disease is the most common vector-borne disease in the United States. According to the Centers for Disease Control and Prevention (CDC), there are an estimated 476,000 cases of Lyme disease diagnosed and treated in the US annually

15%

Lyme disease neuropathy, also known as Lyme neuroborreliosis, occurs in 10–15% of people with untreated Lyme disease

Ticks

Lyme disease is by far the most common tickborne disease

Early diagnosis and treatment are important to stop the progression of the disease. If untreated, the disease can result in neurological disorders such as peripheral neuropathy, including Bell’s palsy, as well as pain, numbness or weakness in the limbs. The onset of peripheral neuropathy typically develops weeks, months or years later, if the disease is left untreated.

While potentially serious, Lyme disease can be treated, especially in the early stages. It is important to take preventive measures when outdoors in areas known to have infected deer ticks. Some helpful steps include: wearing enclosed shoes and light colored clothing; checking clothing and exposed skin frequently for ticks; and using insect repellant containing DEET (Diethyl-meta-toluamide) on skin or clothes.

Stage 1 Lyme Disease Symptoms

(Not all symptoms and signs may be present)

Fever and chills
Muscle and joint pain
Red circular rash
Stiff neck
Swollen lymph nodes

Stage 2 Lyme Disease Symptoms

(Not all evaluation and tests may be necessary)

Irregular heartbeat
Meningitis (fever, stiff neck, severe headaches)
Numbness and pain in arms and legs
Stiff neck
Poor coordination

Stage 3 Lyme Disease Symptoms

(Not all treatments and therapies may be indicated)

Chronic pain in muscles
Problems with sleeping
Numbness and pain in arms and legs
Nervous system problems
Difficulty concentrating
Memory loss
Numbness and tingling
Peripheral neuropathy
Pain, numbness and tingling in limbs
Paralysis of facial muscles (Bell’s palsy)

Tests

(Not all evaluation and tests may be necessary)

Neurological exam
Electromyography
Nerve conduction velocity test
Blood tests, including tests for antibody against the agent that causes Lyme disease and tests to detect the agent itself.

Learn More About tests

Treatment & Therapy

(Not all treatments and therapies may be indicated)

Antibiotics
Intravenous therapy

For Bell’s palsy (facial paralysis)

Eye drops for affected eye
Medications such as steroids to reduce inflammation of nerve and decrease pain
Surgery (in rare cases to improve appearance)
Treatment of underlying inflammatory condition, if present

If experiencing weakness, pain, or inflammation (in limbs or knees)

Ask your doctor about special therapeutic shoes or a knee brace (which may be covered by Medicare and other insurance)
Take safety measures to compensate for loss of sensation
Lyme disease is curable, if treated early

Learn More About treatments

The first sign of diabetic neuropathy is usually numbness, tingling or pain in the feet, legs or hands.

Over a period of several years, the neuropathy may lead to muscle weakness in the feet and a loss of reflexes, especially around the ankle.

As the nerve damage increases, the loss of sensation in the feet can reduce a person’s ability to detect temperature or to notice pain. Because the person can no longer notice when his/her feet become injured, people with diabetic neuropathy are more likely to develop foot problems such as skin lesions and ulcers that may become infected.

Diabetic neuropathy may suddenly flare up and affect a specific nerve or group of nerves. When this occurs, the result may be weakness and muscle atrophy in various parts of the body, such as involvement of the eye muscles or eyelid (e.g., causing double vision or a drooping eyelid) or thigh muscles. Alternatively, neuropathy caused by diabetes may slowly progress over time. It also can interfere with the normal functioning of the digestive system and sexual organs.

Symptoms

(Not all symptoms and signs may be present)

Numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
Indigestion, nausea, or vomiting
Diarrhea or constipation
Dizziness or faintness due to a drop in blood pressure especially when rising to a standing position
Problems with urination
Erectile dysfunction (impotence) or vaginal dryness

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Tests

(Not all evaluation and tests may be necessary)

Comprehensive foot exam
Physical examination
Neurological exam
Electromyography
Nerve conduction velocity test
Quantitive sensory testing (QST)
Nerve or skin biopsy
Blood studies (to verify diabetes (e.g., HbA1C) and to rule out other potential causes)

Learn More About Symptoms

Treatments

(Not all treatments and therapies may be indicated)

The goal of treatment for diabetic neuropathy is to relieve discomfort and to prevent further tissue damage. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet.

Over-the-counter pain medication for mild pain
For severe pain, take over-the-counter pain medication or prescription drugs used for peripheral neuropathy, on a regular basis—rather than waiting until nighttime when symptoms can become more severe
Keep blood sugar levels in normal range
Get regular exercise
Maintain a healthy weight
Antidepressants (for pain relief)
Foot care: inspect your feet daily for injuries
Special Therapeutic shoes (which may be covered by Medicare and other insurance)
Take safety measures to compensate for loss of sensation

Learn More About Symptoms