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Because the prognosis and treatment are very different between Lyme disease and multiple sclerosis, it’s essential to definitively determine which is causing the symptoms in a patient.

Diagnosing multiple sclerosis is quite a task, both for the patient and doctor, since a rigorous battery of tests is required to eliminate other possible factors that could be the cause of symptoms. That’s because multiple sclerosis is a very specific, progressively degenerative disease, and it’s a serious diagnosis. It’s also because there are tons of conditions and diseases that mimic many of those found in MS patients.

For example, when someone develops Lyme disease, many of the symptoms give the appearance of a flare up of multiple sclerosis, leaving patients scared and confused. Some doctors may at first suspect MS, as well, and running the tests can prove one way or another what the actual diagnosis should be. While Lyme disease is no walk in the park, there are treatments for it, just as there are for MS, if the patient goes through the process of getting the proper diagnosis.

What is Lyme disease?

Lyme disease is caused by a bacterium that is spread to humans through tick bites. Not all ticks carry or transmit Lyme disease; in North America, black legged and deer ticks are to blame for cases of Lyme disease. Lyme disease doesn’t necessarily become symptomatic immediately, with symptoms arising anywhere from three to 30 days after the initial bite, on average. However, in some cases, a patient won’t have any symptoms for several months.

There are certain factors that weigh into the chances a person will contract Lyme disease from a tick bite:

  1. What kind of tick bit the patient?
  2. Where was the patient when the bite occurred?
  3. How long was the tick attached to the patient after biting prior to being dislodged?

According to both the CDC and the Cleveland Clinic, the likelihood of getting Lyme disease is negligible if the tick is attached for less than 48 hours. In the vast majority of cases, the tick must be attached for at least that long for any risk of falling ill.

Lyme disease and multiple sclerosis: Symptoms and similarities

When comparing the onset of Lyme disease with the first (or first few) episodes of multiple sclerosis, several similar symptoms arise. In fact, it’s not uncommon for the two to be confused, even by medical professionals. Unless a patient has been somewhere that they would have a high chance of exposure to ticks, most physicians will lean toward MS. However, it is important to rule out all other possibilities first, including Lyme disease.

A patient with either MS or Lyme disease could have symptoms such as:

  • Numbness and tingling, especially in the hands and feet
  • Inflammation in the brain and spinal cord (central nervous system, or CNS)
  • Joint pain (which becomes arthritis with swelling and particularly affects the knees in Lyme disease)
  • Difficulty with mobility
  • Dizziness and vertigo
  • Vision issues, including double or blurred vision, eye pain, and even blindness
  • Severe headaches and migraines, with neck stiffness and pain
  • Cognitive issues, such as memory loss or speech complications
  • Extreme fatigue
  • Muscle pain and weakness, as well as spasms

Because the prognosis and treatment are very different between Lyme disease and multiple sclerosis, it’s essential to definitively determine which is causing the symptoms in a patient. In fact, early detection and diagnosis can greatly benefit patients in both cases, since treating Lyme disease early can negate residual issues and early treatment of MS leads to a better chance of slowing the progression of the disease.

Lyme disease vs MS: The differences

Obviously, the initial trigger for Lyme disease is very different from that of multiple sclerosis. While the reason behind the autoimmune response in the body that causes MS is unknown, it doesn’t seem to be the least bit related to the bacteria that causes Lyme disease. There is no link between a tick bite and MS, despite the fact that ticks also carry other diseases that are transmittable to humans. But the differences don’t end there.

Other differences between the two diseases include:

  • With Lyme disease, the prognosis is quite positive, with the disease being treatable with antibiotics. By contrast, MS has no cure, and the symptoms may go into remission but will return and eventually become constant and worsening. Treatment is geared toward slowing the progression of the disease utilizing immunosuppressants and disease modifying therapies (DMTs).
  • The two conditions share many symptoms, but a few are individual to each disease. For example, Lyme disease typically manifests with a rash that may look like a bull’s-eye, swollen joints, and symptoms like the flu (including body aches, fever, and chills).
  • MS is typically diagnosed in individuals between the ages of 18 and 40. With Lyme disease, this usually occurs between the ages of five and 15 or over the age of 50. In addition, Lyme disease is seasonal, occurring more frequently in spring and summer when people are more likely to be outdoors (hiking, camping, etc. with tick exposure). MS is just as likely to develop at any time of year.
  • Women are three times as likely as men to develop multiple sclerosis. With Lyme disease, more cases occur in men than women.

Conclusion

Many of the same tests are performed to diagnose both diseases, especially since they are necessary to rule out other ailments with similar symptoms. Typically, the physician will take an extensive medical history, do a physical exam, and then request several other tests, including blood tests, an MRI, a spinal tap, and an EP (evoked potential) test, which measures brain activity while certain nerve centers are stimulated. The results of these tests combined typically rule out a number of other diseases and conditions and can spot the difference between Lyme disease and multiple sclerosis. The MRI and spinal tap are especially useful, since Lyme disease doesn’t cause lesions in the brain, and presence of Lyme disease will spark a higher count of particular antibodies in the spinal fluid.

Getting tested early after the onset of symptoms could lead to greater relief. Some patients with Lyme disease, especially those who aren’t treated quickly, find themselves experiencing lingering joint and muscle pain for the rest of their lives. MS patients who begin treatment early are more likely to slow the advancement of the disease and prolong periods between relapses, which helps reduce permanent damage. Speaking to a physician could make a very big difference in overall quality of life for the future in both cases.

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