Neuropathic Pain Syndromes in Neuroborreliosis

Lyme neuroborreliosis is a neurologic condition after infection with Borrelia burgodrferi. It can affect many organ systems, and 10%–15% of individuals develop Lyme disease. Lyme disease can cause lymphocytic meningitis, cranial neuropathies, radiculoneuritis, post Lyme disease syndrome, and chronic Lyme disease. The pathophysiology, neurologic manifestations of Lyme disease, and post Lyme disease syndrome are reviewed. An overview of antimicrobial therapy and treatment of post Lyme disease syndrome is followed by pain in neuroborreliosis and treatment options, which include serotonin-norepinephrine reuptake inhibitors, calcium channel ligands, and opioid analgesics and tramadol. This is followed by nonpharmacologic therapy for neuropathic pain.