Lyme Disease Signs

There are many Lyme disease signs that can be hard to recognize! Since Lyme disease is a multi-systemic illness (affects many parts of the body), there is a multitude of symptoms associated with the illness. Please make a checklist to see how many signs you may have:

Some Lyme Disease Signs include:
    • Flu-like symptoms
    • Fever
    • Headache
    • Extreme fatigue/achiness
    • “Bulls-eye” rash, other rashes (only found in 50% of patients)
    • Malar Flush (over the bridge of the nose and face), including red ear lobes
    • TMJ/ Jaw Pain
    • Neck and/or Back Pain
    • Joint Pain and/or Swelling

A blood test for Lyme disease can be done to check for antibodies of the bacteria that causes Lyme disease. The most commonly used test is the ELISA (enzyme-linked immunosorbent assay). A Western Blot test is done to confirm any positive or abnormal ELISA results. In areas where Lyme disease is more common, your health care provider may be able to diagnose early disseminated Lyme disease (Stage 1) without doing any lab tests.

Other tests that may be done after the infection has become more widespread, include:
    • Electrocardiogram (heart)
    • Echocardiogram (heart)
    • Spinal tap (lumbar puncture to further test spinal fluid)
    • MRI (brain)

 Information Courtesy of Lyme Disease Association

Early detection of Lyme disease signs (Stage 2), which can occur weeks to months after the tick bite, may include:
    • Numbness or pain
    • Paralysis or weakness in the muscles of the face
    • Heart problems, such as skipped heartbeats (palpitations), slowed heart rate, chest pain, or shortness of breath
Symptoms of late disseminated Lyme disease (Stage 3), which can occur months or years after the infection.

The most common Lyme Disease Signs are muscle and joint pain.

Other symptoms may include:

    • Abnormal muscle movement
    • Joint swelling/pain (usually the knee or other large joints)
    • Muscle weakness
    • Numbness and tingling
    • Speech problems
    • Decreased memory or slow thought process (cognition)
    • Personality changes (if severe)
Tick Lifecycle-complications

Typical Course of Lyme Disease Signs

  • Stage 1. In the majority of cases, the first sign of early Lyme disease is the appearance of a bull’s-eye skin rash. It usually develops about 1 – 2 weeks after the bite, although it may appear as soon as 3 days, and as late as 1 month. In some cases, it is never detected. Flu-like symptoms (joint aches, fever, and general fatigue) commonly develop early on as well.

  • Stage 2. Untreated stage 1, the infection spreads through the bloodstream and lymph nodes within days to weeks. This may involve the joints, nervous system, and possibly the heart. Multiple rashes may erupt. If the infection affects the nervous system in stage 2, it most often causes weakness or paralysis in the nerves of the face (Bell’s palsy) or in nerves of the spine.

  • Stage 3. If the disease remains untreated, a persistent infection can occur after a few weeks or months, leading to prolonged bouts of arthritis and neurologic problems (such as concentration problems or personality changes).

***Fatigue is a prominent feature of both early and late stages

The bull’s eye rash (EM), which is considered the classic sign of Lyme disease, may take the following course:
    • It can first appear as a pimple-like spot, which expands over the next few days into a purplish circle. The circle may reach up to 6 inches in diameter with a deeper red rim. In some cases the ring is incomplete, forming an arc rather than a full circle.

    • The center of the rash often clears or may turn bluish. Or secondary rings may develop within the original ring, creating the bull’s-eye pattern. Over the next several weeks, the circular rash may grow to as large as 20 inches across.

    • Patients often describe the sensation of the rash as burning rather than itching.

Up to 20% of people infected with Lyme disease do not exhibit the rash. On dark-skinned people, the rash may resemble a bruise. In most patients, any rash fades completely after 3 – 4 weeks, although secondary rashes may appear during the later stages of disease.


Neurologic Symptoms

Neurologic symptoms can first appear while the initial skin rash is still present or within 6 weeks after its disappearance. Sometimes they are the first symptoms that the patient experiences, but sometimes they may not occur until many months after the tick bite. The most common neurologic symptoms include headaches, sleep problems, and mood disturbance. Memory problems can also occur, as well as nerve damage in arms and legs. Neurologic symptoms typically improve or resolve within a few weeks or months, even in untreated patients.

Bell’s Palsy

In some patients, the facial nerve is affected, which results in Bell’s palsy. This is a sudden weakness and drooping of the facial muscles and eyelid on one side of the face. Nerves around the facial area may also cause numbness, dizziness, double vision, and hearing changes.

Symptoms of Meningitis

Meningitis can occur if the infection takes place in the membranes that surround the brain and spinal cord (the meninges). This can cause:

    • Episodes of headache not relieved by over-the-counter medication
    • Mild stiff neck
    • Sensitivity to light

Symptoms of Lyme Encephalopathy

In some cases of untreated disease, the infection causes a condition called Lyme encephalopathy or neuroborreliosis.This may cause the following symptoms:

    • Unexplained mood changes
    • Depression
    • Trouble concentration and remembering
    • Irritability
    • Feelings of “pins and needles” or numbness in the arms or legs

For Additional information: Lyme Disease Signs

*Note,  these symptoms may get better even without treatment, but the infection is still present. Failure to get treatment will lead to further complications. Untreated Lyme disease can cause severe arthritis and chronic neurological problems (numbness, cognitive problems, shooting pains)

Long Island Stage 3 Lyme Disease

Lyme Disease Long Term Symptoms

If your Lyme Disease goes untreated for a number of years, you can expect to show some or all of these symptoms:

    • Weakness
    • Severe fatigue
    • Partial or complete loss of short term memory
    • Unusual sensitivity to light or loud sounds
    • Loss of appetite
    • Pain that moves from one part of your body to another
    • Heart arrhythmia
    • Loss, feeling in the extremities
    • Difficulty swallowing
    • Depression
    • Seizures
    • Pain behind the eyes



Chronic Lyme disease signs can appear similar and be confused with over 350 different diseases. The chronic Lyme disease symptoms mimic such diseases as multiple sclerosis, rheumatoid arthritis and Parkinson’s disease. In some cases, people can spend years of their lives being treated for the working illness, while Lyme’s disease continues to progress.

No two patients ever experience identical chronic Lyme disease symptoms, another factor which makes it harder to diagnose. The Lyme spirochetes enter the body at the site of the bite and can ultimately make their way anywhere in the body via the blood and lymph system. This basically means that they could cause problems anywhere in the body.