Nervpåverkan från borrelia, neuroborrelios eller neuroborrelia, kan komma ganska tidigt men risken att bakterien ska sätta sig i nervsystemet ökar med tiden som man går obehandlad. Eftersom det kan ge allvarliga symtom och i värsta fall leda till döden är det viktigt att symtomen tas på allvar och att sjukdomen behandlas i tid. Borrelia kan visa sig på många sätt, allt från koncentrationsproblem och minnesproblem till demensliknande symtom både hos unga och gamla. Studier från olika delar av världen visar gång på gång att det är symtom som ska tas på allvar.

Även om äldre drabbas så är uppmärksamheten på neuropsykiatriska sjukdomar större när det gäller barn och unga. Orsaken till att det verkar bli vanligare med neuropsykiatriska diagnoser hos barn och unga är oklar och det finns flera teorier. En av dem har sin grund i att flera studier uppmärksammat ett samband mellan dessa diagnoser och borreliainfektion.

Neuritis, nervinflammation, är en allmän term som anger inflammation i perifera eller kranialnerver. Till de kliniska kännetecknen hör smärta, parestesier, pares eller hypestesi.

Cerebral infarkt innebär uppkomst av områden av nekros, celldöd, i hjärnan till följd av otillräckligt blodflöde, arteriellt eller venöst. Hjärninfarkter indelas allmänt efter hjärnhalva (dvs vänster eller höger), lob (t ex främre lob) , artärnät (t ex främre hjärnartär) och etiologi (t ex emboli).

Intracranialt aneurysm är en medfödd eller förvärvad utbuktning i kärlväggen av blodkärl i hjärnan. Säck- eller bärformade åderbråck är den vanligaste varianten och bildas oftast vid artärförgreningar nära hjärnbasen. Bristning leder till subaraknoidalblödning eller intrakraniella blödningar. Jätteaneurysm (>2,5 cm i tvärsnitt) kan trycka ihop intilliggande vävnadsstrukturer, inkl. okulomotoriska nerven (tredje hjärnnerven).

Vissa symtom kan likna Parkinson’s vilket gör det extra viktigt att kunna utesluta differentialdiagnoser till dem båda så att inte fel behandling ges. Parkinsons sjukdom är en progressiv, degenerativ neurologisk sjukdom som kännetecknas av darrningar, muskelspänning, stelhet, framåtlutande kroppställning, långsamma rörelser och maskliknande ansiktsuttryck. Patologiska kännetecken inkluderar förlust av melatoninneuroner i substantia nigra och andra pigmenterade kärnor hjärnstammen.

Borrelia kan även ge symtom som liknar demens, Alzheimers sjukdom och liknande sjukdomar. Alzheimers är en form av presenil demens som vanligen beror på kronisk, nedbrytande hjärnsjukdom. I sjukdomsbilden ingår för tidigt inträdande av senilitet, förvirring och talrubbningar. Förtviningen av nervceller i hjärnan har likheter med för tidigt åldrande. Dubbelt så många kvinnor som män tycks drabbas.

En sen manifestation av borrelia är encefalit, hjärninflammation. Det är en inflammation i hjärnan orsakad av infektion, autoimmuna förlopp, förgiftning eller andra tillstånd. Virusinfektion är en ganska vanlig orsak till hjärninflammation.

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