Lyme disease is an infectious illness caused by the bacterium Borrelia burgdorferi, transmitted primarily through the bite of infected black-legged ticks. While the infection is known for causing the distinctive bulls-eye rash (erythema migrans) and joint pain, its effects are not limited to the skin and musculoskeletal system. The bacterium can spread throughout the body, eventually affecting the central and peripheral nervous systems. This spread can lead to various neurological complaints, including dizziness.
Dizziness as a Manifestation of Lyme Disease
Lyme disease can cause dizziness, typically when the infection has progressed beyond the early localized stage. This sensation manifests most commonly as either true vertigo or general lightheadedness. Vertigo is characterized by a false sense of motion, often described as the feeling that the environment is spinning or swaying. Lightheadedness is a feeling of faintness or unsteadiness. This type of dizziness may also be linked to Lyme carditis, a complication where the infection affects the heart’s electrical signaling, leading to an irregular heartbeat and subsequent faintness. These symptoms of imbalance usually appear during the early or late disseminated stages.
Neurological and Inner Ear Mechanisms
The reason for dizziness in Lyme disease is often the invasion of the nervous system, a condition termed Neuroborreliosis. The Borrelia bacterium triggers an inflammatory response that targets neurological structures responsible for maintaining balance, frequently affecting the cranial nerves. A specific target is the vestibulocochlear nerve (Cranial Nerve VIII), which handles both hearing and balance. When this nerve becomes inflamed, the disruption to the vestibular system within the inner ear interferes with the brain’s ability to process spatial orientation, producing vertigo. Inflammation in the central nervous system, such as the brainstem, can also disrupt the brain’s processing of balance signals, contributing to persistent unsteadiness.
Associated Symptoms of Neuroborreliosis
Dizziness rarely occurs in isolation when caused by Neuroborreliosis, typically presenting as part of a broader collection of neurological symptoms.
- Severe headaches, which can sometimes indicate meningeal inflammation (Lyme meningitis).
- Nerve pain (radiculopathy), often described as shooting or burning sensations.
- Cognitive difficulties, collectively referred to as “brain fog,” including issues with memory and concentration.
- Sensory disturbances, such as tinnitus (ringing in the ears) and sensitivity to light or sound.
- Facial palsy, caused by inflammation of other cranial nerves, resulting in muscle weakness or drooping.
Diagnosis and Management of Lyme-Related Dizziness
Confirming that dizziness is caused by Lyme disease involves a multi-step diagnostic process. Physicians rely on the patient’s medical history, including potential tick exposure, and a neurological examination to assess balance and coordination. Laboratory testing typically begins with a screening test like the Enzyme-Linked Immunosorbent Assay (ELISA). If the screening test is positive or uncertain, it is followed by a specific Western Blot test to confirm antibodies against Borrelia burgdorferi. If Neuroborreliosis is suspected, a lumbar puncture (spinal tap) may be performed to analyze the cerebrospinal fluid for evidence of infection. Once confirmed, Lyme-related neurological symptoms, including dizziness, are treated with a course of oral or intravenous antibiotics, such as doxycycline or ceftriaxone.