Lyme Disease and Facial Paralysis: Late Symptoms

Lyme disease is passed to humans through the bite of an infected black-legged tick that carries bacteria called Borrelia burgdorferi or, rarely, Borrelia mayonii. In most cases, the tick must be attached to the area for 48 hours before the bacteria can be transmitted.

Each year approximately 30,000 cases of Lyme disease are reported, but this number does not reflect all instances. Recent estimates suggest that nearly 476,000 people in the United States are treated for Lyme disease each year, but that number likely includes patients who were not actually infected.

Learn more about the signs of Lyme disease, including facial paralysis, diagnosis, and treatment of the disease.

Early Signs of Lyme Disease

The earliest signs of Lyme disease typically occur between three and 30 days after infection.

Early Infection, Stage 1

About 70%–80% of infected people will get a rash called erythema migrans (EM). On average, this occurs around day seven but can happen later.

The rash begins at the site of the tick bite and expands. The red or bluish rash is usually circular and may or may not have central clearing. The rash can be warm to the touch but is rarely painful or itchy. The rash can enlarge and resemble a bull's-eye, or target, when it fades.

Other symptoms of Lyme disease include:

• Fever
• Chills
• Headache
• Fatigue
• Muscle and joint aches
• Swollen lymph nodes may occur in the absence of rash

Early Infection, Stage 2

Within weeks or months after a tick bite, a person with Lyme disease may experience other symptoms, which can include:

• Headaches and neck stiffness
• Joint pain
• Rashes on different parts of the body
• Swelling of the large joints, such as the knees
• Irregular heartbeat (Lyme carditis)
• Nerve pain
• Pain in the tendons, muscles, joints, and bones that come and go
• Numbness, tingling, and shooting pain in the hands and feet
• Dizziness or shortness of breath
• Facial palsy
  

Late Stages of Lyme Disease

Late-stage (stage 3) infection occurs months after the original illness and typically consists of Lyme arthritis (joint swelling as opposed to muscle/joint pain, which is commonly seen in earlier stages of the illness).

Lyme Disease and Facial Palsy

When Lyme disease affects the nerves in the face, it can result in facial drooping on one or both sides. This is referred to as Lyme neuroborreliosis (LNB) or neurological Lyme disease.

Facial drooping can accompany numbness, pain, weakness, impaired smiling and chewing, visual disturbances (double blinking or trouble blinking), and meningitis symptoms such as fever, stiff neck, and severe headache.

Diagnosis

Lyme disease is diagnosed based on clinical symptoms and exposure to ticks. Usually, the presence of a rash is enough to diagnose Lyme disease.

If a person does not have a rash, blood work that tests for antibodies (IgM and IgG) made by the body in response to infection might be checked. However, it can take time to make these antibodies, and they can last long after the disease is gone and treated.

Treatment

Removing a tick quickly (within 24 hours) will significantly reduce your chances of getting Lyme disease. But if you have confirmed Lyme disease, the usual course of treatment will be antibiotics. The type of antibiotics and duration of treatment will depend on your age, your medical history, other existing medical conditions, and the associated symptoms.

Treatment for facial palsy can last up to 21 days or more. The earlier a person receives treatment, the better the outcome. Consult with your healthcare provider or an infectious disease specialist for treatment recommendations.

Summary

Early Lyme disease symptoms include a rash that can present differently in people but often looks like a bull's-eye. Later a person with Lyme disease may experience other symptoms, some of which can be neurological such as facial palsy. Early detection and treatment can help to cure and prevent further complications of Lyme disease. Contact your healthcare provider immediately if you have been exposed to a tick or have Lyme disease symptoms.

A Word From Verywell

If you plan to be outdoors in wooded or grassy areas, take preventive measures as best as possible. Cover exposed areas of skin with long sleeves, pants, high socks, and protective boots. Check common body parts where ticks may reside, including, under the arms, in and around the ears, inside the belly button, behind the knees, around the hairline, between your legs, and around the waist. Contact your healthcare provider immediately if you suspect a tick has bitten you.