What’s the Difference Between Neurologic Lyme Disease and MS?

SYRITSYNAOlga Syritsyna, MD
Multiple Sclerosis Comprehensive
Care Center

Hearing the words “you have Lyme disease” or “you have MS (multiple sclerosis)” can be quite unsettling. And to complicate matters, when Lyme disease affects the central nervous system, the symptoms can be very similar to MS. So it can be hard to tell the difference to the untrained eye. Many doctors are generalists and not specially trained to diagnose either disease. Dr. Olga Syritsyna is a neurologist with subspecialty training in neurologic Lyme disease and MS.

What is neurologic Lyme disease?
First, let’s start with defining Lyme disease. It’s a seasonal tick-borne infection caused by the borrelia burgdorferi bacteria that can affect multiple organs and systems in the body. It’s named after Lyme, CT, where it was first identified in 1975. In about 15 percent of cases, Lyme disease affects the central nervous system. When it does, it is known as neurologic Lyme disease. Sometimes, people who think they may have Lyme disease find out they have MS (an immune-mediated central nervous system disorder). Lyme disease as an infection can act to trigger MS attacks. This is why being seen by a neurologist specially trained to know the differences is key.

What symptoms does it have in common with MS?
Neurological symptoms can develop days to weeks to months after the Lyme agents are inoculated into the skin at the tick bite site. This is the site at which the bull’s eye rash appears. Suggestive symptoms are a headache and stiff neck. Other symptoms may include facial nerve palsy (Bell’s palsy), blurred or double vision, spine pain, confusion and fatigue. Neurologic Lyme disease may also affect one’s thinking, memory and ability to process information. Some of these symptoms are also common to MS.

Who is at risk for neurologic Lyme disease?
The majority of people who develop neurologic Lyme disease become ill during the summer months. The blacklegged ticks that cause Lyme disease live in moist and humid environments, in and near wooded or grassy areas. To decrease your risk of getting Lyme disease, a few simple precautions can help: Cover up. Use insect repellent. Do your best to tick-proof your yard. Check yourself, your children and your pets for ticks. Don’t assume you’re immune. Remove a tick as soon as possible with tweezers.

Who is at risk for MS?
Ninety percent of people who are diagnosed with MS develop it between the ages of 15 and 50, but it can occasionally strike those both younger and older. MS is more common in women (currently there is a 3:1 ratio). Vitamin D deficiency, smoking and having had mononucleosis all increase one’s risk for MS. There are low-, medium- and high-risk zones. Northern Europe, Canada and the United States are three examples of high-risk zones for MS.

Why choose Stony Brook for diagnosis and treatment of neurologic Lyme disease?
For neurologic Lyme disease, Stony Brook has extensive experience in detecting antibodies to the borrelia burgdorferi bacteria that is carried by ticks and can affect the central nervous system. We do frequent lumbar punctures (spinal taps) and perform a variety of tests on cerebrospinal fluid.

What about MS diagnosis and treatment at Stony Brook?
We’ve seen the best long-term outcomes when treatment is started early. We now know that ongoing, accumulating permanent damage in untreated patients with MS occurs even when there are no symptoms. This makes early diagnosis and a long-term plan to manage the disease essential. At Stony Brook, treatment of MS occurs on many levels: disease modifying therapies, symptom management, treatment of acute attacks, ongoing health evaluations, lifestyle modifications and more. We also offer infusion therapy when a patient’s condition can’t be effectively treated by medications taken by mouth (orally). An infusion of a drug is typically administered intravenously (into the veins). Our patients also have access to many ongoing clinical research trials for MS — a number of which have been developed right here at Stony Brook and can be viewed at: bit.ly/MSclinicaltrials.

To make an appointment with a neurologist trained in both neurologic Lyme disease and MS, call (631) 444-2599.