Lyme disease can affect people very differently, partly because of different strains of the disease. It is known as a great imitator of other diseases, which can make diagnosis difficult. Joseph J. Burrascano JR. M.D. gives a list of potential symptom in the pamphlet Advance Topics in Lyme Disease: Diagnostic Hints and Treatment Guidelines for Lyme and other Tick Borne Illnesses. For a more complete list of symptoms, please see Symptoms & Characteristics A compilation of peer-reviewed literature reports. Please bear in mind that according to Lyme Disease Action, “around 50% of people do not see a rash,” which is often used as a key diagnostic marker:

‘EM’ rash(discrete circle)

Spotted rash over large areas

Linear red streaks

Persistent swollen glands

Sore throat


Sore soles, esp. in the AM

Joint pain

Joint swelling

Unexplained back pain

Stiffness of the joints or back

Muscle pain or cramps

Obvious muscle weakness

Twitching of the face or other muscles

Confusion, difficulty thinking

Difficulty with concentration, reading, problem absorbing new information

Word search, name block

Forgetfulness, poor short term memory, poor attention

Disorientation: getting lost, going to wrong places

Speech errors- wrong word, misspeaking

Mood swings, irritability, depression

Anxiety, panic attacks

Psychosis (hallucinations, delusions, paranoia, bipolar)




Light sensitivity

Sound sensitivity

Vision: double, blurry, floaters

Ear pain

Hearing: buzzing, ringing, decreased hearing

Increased motion sickness, vertigo, spinning

Off balance, “tippy” feeling

Lightheadedness, wooziness, unavoidable need to sit or lie

Tingling, numbness, burning or stabbing sensations, shooting pains, skin hypersensitivity

Facial paralysis-Bell’s Palsy

Dental pain

Neck creaks and cracks, stiffness, neck pain

Fatigue, tired, poor stamina

Insomnia, fractionated sleep, early awakening

Excessive night time sleep

Napping during the day

Unexplained weight gain

Unexplained weight loss

Unexplained hair loss

Pain in genital area

Unexplained menstrual irregularity

Unexplained milk production; breast pain

Irritable bladder or bladder dysfunction

Erectile dysfunction

Loss of libido

Queasy stomach or nausea

Heartburn, stomach pain



Low abdominal pain, cramps

Heart murmur or valve prolapse?

Heart palpitations or skips – “Heart block” on EKG

Chest wall pain or ribs sore

Head congestion

Breathlessness, “air hunger”, unexplained chronic cough

Night sweats

Exaggerated symptoms or worse hangover from alcohol

Symptom flares every 4 wks.

Degree of disability

(Burrascano 2008: 9-10)