Neurologic abnormalities of late Lyme disease usually develop a year or more after illness onset:
- progressive encephalomyelitis
- focal encephalitis
- cerebral vasculitis
- stroke
- multi-infarct dementia
- leukoencephalitis
- brain stem encephalitis
- late encephalopathy
- cerebellar ataxia
- transverse myelitis
- progressive spastic paraparesis or quadriparesis
- cognitive deficits
- affective disturbance
- seizures
The most common late CNS abnormalities are vague neuropsychiatric deficits such as somnolence, emotional lability, depression, impaired memory, and behavioral symptoms. The best-defined late CNS abnormality, however, is progressive Borrelia encephalomyelitis.27
Seizures can occur in 7% of these cases.25 Focal motor, partial complex, and generalized convulsions can all occur.
Adapted from: Goldstein MA and Harden CL. Infectious states. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;83-133.
With permission from Elsevier (www.elsevier.com).