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Lyme Disease versus Multiple Sclerosis


Lyme disease is one of a number of conditions that may present neurological symptoms similar to multiple sclerosis. Knowing the similarities and differences between Lyme disease and MS can help you and your healthcare provider identify the cause of your symptoms.

What is Lyme disease?

Lyme disease is a tick-borne illness that causes symptoms such as fever, headache, stiff neck, fatigue and muscle and joint pains. It’s caused by a bacterium known as Borrelia burgdorferi, which is carried by a deer tick. Those bitten by an infected tick may develop the first signs of Lyme disease within days or months. Of those infected with Lyme disease, 60% to 80% get a large, reddish rash sometimes described as a bullseye.

Similarities between Lyme disease and multiple sclerosis

Lyme disease can cause delayed neurologic symptoms similar to those seen in MS. These symptoms include weakness, blurred vision caused by optic neuritis, dysesthesias (sensations of itching, burning, stabbing pain or “pins and needles”), fatigue, confusion and cognitive dysfunction. Lyme disease symptoms may come and go, as they do with relapsing-remitting MS. In addition, Lyme disease occasionally produces other abnormalities that are similar to those seen in MS, including positive findings on magnetic resonance imaging (MRI) scans of the brain and cerebrospinal fluid analysis (CSF).

These similarities in symptoms and test results have led some people with MS to seek testing for the presence of antibodies to Borrelia to determine if their neurologic symptoms are the result of Lyme disease or truly MS. The distinction is important because Lyme disease, especially when treated early, often responds to antibiotic therapy, whereas MS does not.

Talk to your healthcare provider if you are experiencing any of these symptoms.

How can you tell the difference between MS and Lyme disease?

There are several differences between Lyme disease and MS. Learn about key differences in the causes, symptoms and treatments below.

Difference in the causes of Lyme disease and MS
  • Lyme disease is an infection caused by a bite from a tick infected with Borrelia burgdorferi bacteria.
  • Although the cause of MS is not conclusively known, it is not believed to be bacteria and is not the result of a tick bite.
Differences in Lyme disease and MS symptoms
  • Symptoms of Lyme disease (and not of MS):
    • Skin rash
    • Fever
    • Muscle aches
    • Swollen lymph nodes
    • Headache
    • Joint pain
  • Symptoms of MS (and not of Lyme disease):
    • Muscle spasticity
    • Bowel or bladder problems
    • Tremor
Difference in treatments of Lyme disease and MS
  • Lyme disease is treated with antibiotics and can be cured when detected early.
  • Currently, no known cure exists for MS. Treatment includes disease-modifying therapies (DMTs) and symptom management.

The danger of misdiagnosing MS and Lyme disease

Because MS and Lyme disease do have certain similarities, people affected by them may be misdiagnosed. This can have serious health consequences either way.

For instance, people with Lyme disease who are wrongly diagnosed with MS may be placed on disease-modifying therapies that alter or suppress the immune system. This can put them at greater risk of side effects and infections.

People who have MS and are misdiagnosed with Lyme disease risk a delay in getting the treatment they need. This can increase their chances of relapses and progression.

If you suspect that you have been misdiagnosed, see a neurologist to discuss your medical history and have the necessary tests run.


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