If you’ve ever bonked your head hard enough to sustain a concussion or mild brain injury, you know firsthand how scary and unpleasant it can be. But what happens when those symptoms that pop up after your injury stick around – lingering for weeks, months, or even years?

This is the frightening and life-altering reality for people struggling with a condition known as persistent post-concussion syndrome. While at first glance it seems to make sense that these ongoing symptoms are simply a result of the initial injury, as it turns out, it’s actually a little more complicated than that. Research is revealing that these perplexing and persistent symptoms may actually be triggered by something that seems quite unrelated – Lyme disease and Lyme co-infections. 

Today we’re going to look at exactly what persistent post-concussion syndrome is and explore how the microbes in Lyme disease and Lyme co-infections could be triggering these ongoing neurological symptoms. Let’s dive in.

What is Persistent Post-Concussion Syndrome?

Persistent post-concussion syndrome, also referred to as persistent post-concussive syndrome, is a condition that can sometimes occur after a mild traumatic brain injury. You see, your brain is composed of billions of microscopic cells that communicate amongst themselves and the rest of your body through a complex network of hormones, signaling molecules, and chemical messengers known as neurotransmitters. These communication chemicals trigger your brain cells to fire off electrical impulses – allowing your brain to almost instantaneously send and receive crucial information to and from the rest of your brain and body.

This conglomeration of cells that make up your brain tissue are delicate – which is why your brain is encased within the confines of your skull for protection. But if you receive a blow or jolt to your head, it can essentially send your brain ricocheting around within your skull. This sudden movement can damage the cells in your brain – causing them to stretch, bend, or even break.

This injury to your brain cells can destabilize them – disrupting their ability to function properly. This can lead to your brain cells misfiring, miscommunicating, and mistakenly releasing different levels of signaling molecules. In addition, this injury to your brain can trigger significant inflammation known as neuroinflammation. This injury paired with a spike in neuroinflammation can lead to a whole host of unpleasant symptoms.¹

What Are the Symptoms of Persistent Post-Concussion Syndrome?

Normally when you sustain a mild traumatic brain injury or concussion, your brain is injured and thrown off-kilter for a short period of time. Once your body is able to ramp up inflammation, address the injury, and initiate healing, your symptoms will resolve. But in post-concussion syndrome, the unpleasant symptoms that come along with your concussion seem to linger for much much longer.

Symptoms of persistent post-concussion syndrome include:^2,3

• Headache
• Fatigue
• Sensitivity to light or sound
• Vision changes like double or blurred vision
• Hearing loss or the development of tinnitus (ringing in the ears)
• Reduced sense of smell and/or taste
• Insomnia or significant changes to sleep patterns
• Dizziness
• Mood changes like feeling depressed, anxious, or irritable
• Difficulty managing emotions and sudden emotional outbursts
• Personality changes and inappropriate behavior
• Difficulty concentrating, learning new things, or remembering things
• Slowed reaction times
• Confusion

These frustrating and debilitating symptoms can persist for weeks, months, or even years after the initial injury. Researchers have been searching for answers to this perplexing condition and may have uncovered a fascinating and promising new piece to the puzzle.

As it turns out, these ongoing symptoms may actually be related to an entirely separate condition known as Lyme disease.

What Is Lyme Disease?

Lyme disease is a condition triggered when you contract a microscopic bacteria known as Borrelia burgdorferi. This stealthy microscopic invader is transmitted to humans almost exclusively through tick bites. If you’re bitten by a tick, this creepy crawler can unwittingly introduce Borrelia burgdorferi directly into your bloodstream.

If Borrelia burgdorferi is transmitted into your bloodstream, it goes straight to work – hijacking your cells and manipulating them to ensure it can evade being neutralized by your immune system. As this malicious microbe exploits your own cells, it alters their ability to function while simultaneously triggering widespread inflammation. This alone can trigger a host of troublesome symptoms.⁴

But to make matters worse, Borrelia burgdorferi oftentimes brings friends along – creating co-infections alongside Lyme disease.

What Are Lyme Co-infections?

A Lyme co-infection refers to the concurrent contraction of multiple microbes. Because ticks can carry a cocktail of infectious microbes, they can easily transfer multiple pathogens to you when they sink their teeth into you.⁵ Some commonly seen Lyme co-infections include:

• Anaplasma and Ehrlichia
• Babesia
• Bartonella
• Rocky Mountain spotted fever
• Tick-borne relapsing fever

Co-infections make the waters even murkier when it comes to diagnosis and treatment. Because Lyme and Lyme co-infections can work in cahoots – enhancing and amplifying each other's symptoms and making it difficult to differentiate what’s causing the vague constellation of symptoms.

And some of the most perplexing and frustrating effects of Lyme and Lyme co-infections is their impact on your neurological system.

Can Lyme Disease Cause Neurological Issues?

Lyme disease and Lyme co-infections can throw your entire body out of whack – triggering a whole slew of vague, seemingly unrelated symptoms. And one body system that Lyme can have particularly pronounced effects on is your neurological system. Just some of the neurologically-related issues that have been linked to Lyme disease and Lyme co-infections include:^6,7

• Extreme fatigue
• Headaches
• Dizziness
• Cognitive impairments like difficulty remembering, concentrating, or processing new information
• Mood changes like depression, anxiety, and/or irritability
• Sleep disturbances
• Hearing loss or development of tinnitus (ringing in the ears)

Do any of those symptoms look familiar? If you’re thinking that the list of neurological symptoms associated with Lyme disease looks eerily similar to the list of symptoms seen in post-concussive syndrome, you’re absolutely right.

So how on earth can a bacterial infection be linked to persistent post-concussion syndrome?

The Link Between Lyme and Persistent Post-Concussion Syndrome

While we don’t yet have all the answers, studies have confirmed that there is a clear link between Lyme disease and post-concussion syndrome – with an alarming number of individuals struggling with post-concussive syndrome testing positive for Lyme disease and other underlying co-infections. It’s speculated that some of these patients' symptoms are not being triggered by residual effects of the initial brain injury, but rather by undiagnosed chronic Lyme disease.⁸

So how can this be? How can the line between the initial brain injury and an underlying infection become so blurred that they seemingly blend together – with brain injury symptoms simply persisting long after the injury was sustained? Again, we don’t have all the answers, but it’s speculated it may go something like this:

• Microbial latency: Borrelia burgdorferi and other co-infections are notorious for their ability to remain latent – essentially cloaking themselves to evade capture by your immune system and lying in wait within your cells. It’s not uncommon for people to contract Lyme or other co-infections and have no inkling that they were even bitten by a tick.
• Watchful Waiting: These stealthy microbes are opportunistic. They hide out and keep a low profile, watchfully waiting for any chance they might have to reactivate or “turn on” and begin taking over your own cells. 
• Microbial reactivation: Any shift in your internal homeostasis that puts a damper on your immune system's ability to neutralize a microbial reactivation signals an opening for these sneaky microbes to reactivate. A mild head injury causes damage and significantly upregulates inflammation – shifting your immune system's focus onto healing your brain and regulating this spike in inflammation.  
• Microbial takeover: Once they sense a chance to wreak havoc and proliferate without fear of being eradicated by your immune system, Borrelia burgdorferi and other co-infections get straight to work – hi-jacking and exploiting as many of your cells as they can. As your immune system is distracted and preoccupied with recovering from your mild brain injury, these microbes are able to get a stronghold by targeting your weakest and most inflamed body system – your neurological system.
• Persistent symptoms: As these microbes make themselves at home and continue proliferating and causing damage, the line between symptoms caused by your brain injury and the symptoms caused by the underlying infection becomes blurred. And as your brain injury heals and those symptoms resolve, these stealthy microbes are more than happy to pick up where your brain injury left off – continuing the cycle of debilitating symptoms.

While more time and research are needed to truly understand the relationship between post-concussion syndrome and the microbes that trigger Lyme disease and other co-infections, this understanding gives us exciting new insight into how we can treat those suffering from lingering symptoms after a mild brain injury.

Are You Struggling With Ongoing Symptoms After A Concussion or Mild Brain Injury?

If you’ve suffered a concussion or mild brain injury and are having lingering, persistent symptoms, there may be something more going on. This discovery of the connection between persistent post-concussion syndrome and Lyme disease gives us some promising new tools in the treatment of this perplexing and life-hindering condition. So if you’re grappling with these ongoing symptoms and are searching for answers, I strongly encourage you to seek out the guidance of a Lyme literate Integrative and Functional Medicine Practitioner to help you identify any underlying imbalances that may be contributing to your symptoms. 

While we may not have all of the answers, a functional medicine practitioner can help arm you with an arsenal of tools, tactics, and strategies to reverse underlying imbalances, support healing, and optimize your road to recovery. Healing from post-concussion syndrome and/or Lyme disease can be a challenging and arduous road – so don’t go at it alone.

As a functional medicine doctor myself that has helped countless patients navigate the waters of chronic Lyme disease, I am dedicated to providing as much education and support as possible for those struggling with this complex and difficult-to-pinpoint disease. If you’re concerned about Lyme, I encourage you to head over and check out my library of articles all about Lyme disease and Lyme co-infections by clicking right here. And if you want to get my best content delivered directly to your inbox, you can sign up for my weekly newsletter by entering your name and email address in the form below!

Now it’s time to hear from you. Were you surprised to learn that persistent post-concussion syndrome could actually be a case of underlying Lyme disease? If you’ve recovered from persistent post-concussion syndrome, what strategies helped you the most? Leave your questions and thoughts in the comments below!

Resources:

1. What happens to your brain when you get a concussion? — Concussion Alliance
2. Post-concussion Syndrome (Causes, Symptoms, and Treatment) | Patient
3. Postconcussive Syndrome – StatPearls – NCBI Bookshelf (nih.gov)
4. Borrelia burgdorferi hijacks cellular metabolism of immune cells: Consequences for host defense – ScienceDirect
5. Lyme Disease Co-Infection | NIH: National Institute of Allergy and Infectious Diseases
6. Chronic Neurologic Manifestations of Lyme Disease | NEJM
7. Lyme Disease | National Multiple Sclerosis Society (nationalmssociety.org)
8. Frontiers | The prevalence of Lyme disease and associated coinfections in people with persistent post concussive syndrome (frontiersin.org)