What Are The Symptoms?

Many body systems can be affected by Lyme disease. Symptoms vary from person to person and can come and go. Symptoms are generally classified into early or late. Early symptoms occur days to weeks after a person becomes infected. Early symptoms include:

• Flu-like symptoms such as muscle aches, joint pain, fatigue, headache, stiff neck, chills, fever, or swollen lymph nodes.
• Paralyzed muscles of the face.
• Palpitations (common) or disturbances of heart rhythm (rare).
• An expanding rash called erythema migrans, or EM. The EM appears 1-30 days after the bite of an infected tick, expands over a one to two week period, and then disappears. More EMs, not necessarily at the site of the tick bite, can show up later. The EM is usually painless. The EM varies in shape and appearance. On dark skin the EM can look more like a bruise. The EM is not present in some people, or it may occur on a part of the body that is difficult to see.

Painful redness that occurs less than 24 hours after a tick bite and does not expand is more likely to be a local allergic reaction to the tick's saliva. These symptoms can disappear without treatment but the infection may still be present. If early Lyme disease symptoms are not recognized and treated adequately, the disease may progress and be more difficult to treat.

Late symptoms occur weeks, months, or years after becoming infected. Late symptoms may be the first sign of Lyme disease in some people. Late symptoms include:

• Numbness, tingling, or burning feelings in arms and legs. Muscles of the face, arms, or legs may twitch or become weak or paralyzed. Sharp pain in the arms, legs, neck, and back, may occur. Increased sensitivity to light may be present.
• Swelling and pain of one or a few joints, especially the knees. Joint swelling sometimes moves from one joint to another, and may come and go.
• Difficulties with memory, concentration, learning, or speech in both children and adults.
• Some Lyme disease patients also experience mood swings, depression, or abnormal thought processes.

Diagnosis and Treatment

People with symptoms of Lyme disease should see their doctor as early as possible. Some tick-borne diseases in California (e.g., anaplasmosis, ehrlichiosis and babesiosis), as well as other diseases, can produce symptoms similar to Lyme disease. Thus, Lyme disease can be difficult to diagnose.

A physician diagnoses Lyme disease based on symptoms. Additional information useful to a physician in making a diagnosis of Lyme disease include:

• Patient had a tick bite or was in an area where ticks occur. Because ticks are small, some people do not notice that they have been bitten.
• Blood tests, but these need to be interpreted carefully.

Prompt treatment with antibiotics during early Lyme disease can cure the infection and prevent complications of late Lyme disease. If treatment is delayed, treatment can be difficult and recovery may take longer.