Lyme disease:
what it leaves behind in the nervous system
Whether the Borrelia are still active is one question. What they have left behind in your nervous system is another, and it is rarely asked. As the neurological partner of the Lyme centre at Clinicum St. Georg we ask it: with measurement, and with the aim of restoring functional balance, as far as possible without drugs.
- Free
- No obligation
- Reply within 2 business days
- Outpatient · Bad Aibling
- Non-invasive
Free & non-binding · usually a reply within 2 business days · confidential
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The antibiotics are long finished, the blood work is called normal, and yet concentration, energy and sleep are missing, sometimes along with the belief that anyone is still listening. Between “this cannot be Lyme any more” and “this is all Lyme” there is rarely room for you. Here you get that room. We take your symptoms seriously, measure carefully and tell you what we see and what we do not.
In Germany an estimated 60,000 to well over 200,000 cases of Lyme disease occur each year; in roughly 3–15 % the nervous system is involved, and about one in ten patients reports persistent symptoms even after guideline-based antibiotic therapy.
Symptoms have a map
Borrelia are spiral-shaped bacteria that can enter the skin, joints, heart and nervous system after a tick bite. When they reach the nervous system, physicians speak of neuroborreliosis. Early neuroborreliosis (weeks to months after the bite) usually presents as painful nerve-root inflammation, facial palsy or mild meningitis; it is readily detectable in the spinal fluid and usually responds well to antibiotics. The rare late neuroborreliosis can affect the spinal cord and brain months to years later. And then there is the large group this page is mainly about: people whose infection was treated and whose nervous system still does not find its way back to balance. Concentration, memory and word-finding (the central executive and attention networks), mood and drive (the limbic network), pain processing and stimulus filtering (the salience network) and the autonomic regulation of heart rate, blood pressure, sleep and temperature stay disturbed. Three mechanisms interlock here, and each has a consequence for the plan. The immune system: a persistent activation of the brain’s immune cells (neuroinflammation, visible in PET pilot studies of post-Lyme symptoms) changes how networks fire; whoever stimulates only the network while the infection keeps running is working against a motor that has not been switched off. That is why the question of infection activity is settled first. The autonomic nervous system: damage to the thin nerve fibres (small-fibre neuropathy) with tingling, burning pain and circulatory problems up to POTS shows in heart rate variability; that is why we measure it, and why regulation often begins at the vagus nerve. And the mitochondria: after an infection the energy production of nerve cells stalls, and networks lose performance before any scan shows it; that is why micronutrients and metabolic values belong in the assessment. What remains is often a self-regulation of the brain networks that has fallen asleep and persists even when the pathogen is long gone as the driving force.
For an overview of the six brain networks and a first orientation, see the Brain Network Analysis.
The assessment first, then your program.
The Douwes Brain Center is the neurological side of the Lyme centre at Clinicum St. Georg, where more than 12,000 people with Lyme disease have been treated since 1994. The question of whether and how an infection is still active (serology, lymphocyte transformation test, spinal fluid, clinical picture) and the antimicrobial or integrative treatment, such as whole-body hyperthermia or apheresis, remain with the centre’s infectious-disease colleagues. We answer the question that stayed open there until now: what Lyme disease has left behind in the nervous system and how it can be brought back into order. In three steps. 1 · Assessment. History, existing findings, questionnaires on fatigue, pain, sleep and mood, clinical examination, heart rate variability and autonomic function tests, standardised cognitive tests and lab values (inflammation, micronutrients, thyroid), brought together into one clinical picture. A qEEG brain mapping with a network profile is added when brain fog, slowing or mood are in the foreground and we need to know which network to target. 2 · Regulate. Neuromodulation is one building block here, chosen by your profile: taVNS to calm the autonomic nervous system and the inflammatory axis, carefully dosed rTMS or tDCS for fatigue, cognitive slowing, pain or low mood, neurofeedback as self-regulation training and, where useful, photobiomodulation for the mitochondria. Beside it stand sleep, nutrition, micronutrient infusions used selectively and sparingly, and psychological support after years of fighting for a diagnosis. We never change existing medication without your treating physicians. 3 · Restore. Function, sleep and quality of life, with a follow-up measurement at the end so you can see what has changed. The program complements infectious-disease treatment and does not replace it.
Our aim stays the same: to restore functional balance, with as little medication as possible and a life with high quality of life as the measure.
You don’t have to decide anything today. A 15 to 20 minute conversation is enough to know whether an assessment is worth it for you.
Free & non-binding · usually a reply within 2 business days · confidential
Who it is for, and who it is not for
A good fit if …
- Your Lyme disease was treated, but concentration, energy, sleep or mood have not recovered
- You have tingling, burning pain, a racing heart when standing or an exertion intolerance that nobody can place
- You are a patient of the Lyme centre and want the neurological side measured and addressed specifically
- You are looking for a drug-sparing, measurement-based path — complementing infectious-disease treatment
Less suitable if …
- You have acute neurological deficits (facial palsy, severe nerve pain, fever with a stiff neck) — that belongs immediately in acute neurological care
- You expect us to settle the infection question or prescribe antibiotics — that stays with the infectious-disease colleagues
- You expect a guarantee — serious medicine does not offer one
In an acute crisis or having suicidal thoughts? Please seek immediate medical or emergency help — in Germany call 112, or the free 24/7 helpline Telefonseelsorge 0800 111 0 111.
The first consultation is free. We discuss the scope, duration and cost of any program openly afterwards, outpatient, here in Bad Aibling.
What the research shows
Peer-reviewed work on Lyme Disease & Neuroborreliosis and the relevant procedures, graded by evidence level. No study proves an individual outcome.
In short: for some procedures the evidence is solid, for others still early. Where your case stands is settled in the assessment, and the program follows from it.
Guidelines for diagnosis and treatment in neurology — Lyme neuroborreliosis
EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis
Lyme borreliosis
Lyme neuroborreliosis — epidemiology, diagnosis and management
Prevalence and spectrum of residual symptoms in Lyme neuroborreliosis after pharmacological treatment: a systematic review
Treatment of post-treatment Lyme disease symptoms — a systematic review
Randomized trial of longer-term therapy for symptoms attributed to Lyme disease
Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease
Cognitive decline in post-treatment Lyme disease syndrome
Imaging glial activation in patients with post-treatment Lyme disease symptoms: a pilot study using [11C]DPA-713 PET
Association of small fiber neuropathy and post treatment Lyme disease syndrome
Postural orthostatic tachycardia syndrome following Lyme disease
Neuropsychiatric Lyme disease and vagus nerve stimulation
Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis
A mechanistic analysis of the neural modulation of the inflammatory system through vagus nerve stimulation: a systematic review and meta-analysis
Transcutaneous auricular vagus nerve stimulation: mechanisms, applications, and research progress
The effects of noninvasive vagus nerve stimulation on fatigue and immune responses in patients with primary Sjögren’s syndrome
Effect of repetitive transcranial magnetic stimulation on long COVID-19 with fatigue and cognitive dysfunction
Transcranial direct current stimulation for post-COVID fatigue: a randomized, double-blind, controlled pilot study
Repetitive transcranial magnetic stimulation ameliorates symptoms in patients with myalgic encephalomyelitis (chronic fatigue syndrome)
More studies across all conditions: Science & Studies.
There are as yet no large controlled trials of neuromodulation specifically for post-Lyme symptoms; the evidence comes from related post-infectious conditions such as Long COVID and ME/CFS, from studies of fatigue, pain and depression, and from mechanistic research on the vagus nerve and inflammation. We transfer it with judgement, dose carefully and re-measure, as an individual, informed treatment attempt.
A real doctor. A real clinic.
Dr. med. univ. Julian Douwes · Medical Director
Part of Clinicum St. Georg, under the medical direction of Dr. med. univ. Julian Douwes. Outpatient, evidence-graded, without medication as the first step — tailored to your profile. More on our program.
- 30+ Years of clinical heritage
- 90+ Countries patients travel from
- 30,000+ Treatment sessions delivered
In three calm steps
Lyme Disease & Neuroborreliosis: let’s talk about your path.
In a free consultation we clarify whether and how our measured program could fit you — no obligation, fully confidential.
Free & non-binding · usually a reply within 2 business days · confidential