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 (

Authored By: 
MA Goldstein
Cynthia L. Harden MD
Steven C. Schachter, MD
Authored Date: 
Reviewed By: 
Steven C. Schachter, MD
Sunday, February 29, 2004