If you experience difficulty walking,

Keeping your balance,

Preventing falls and have an unsteady gait and/or ataxia,

The quotes (with sources) shared below may be helpful

As supporting documentation of your condition.

LB [I have suffered injuries due to falls and balance issues due to the Lyme disease. Over the years I experienced multiple contusions, bruises, cuts, strained muscles, strained wrists, abrasions and other injuries from running into door jams, cabinet doors, falling off sidewalks, falling down ramps, and slip/fall accidents in general. I have particular difficulty and repeated incidents/injuries from falling while in the shower.

The instability of lower limbs, balance problems, nerve involvement and resulting weakness have required the use of a cane, walker, leg braces and a wheelchair at various times.]

“The [a] 9-year old boy diagnosed with Lyme disease] developed severe headache and difficulty walking... On December 7, he was unable to walk without support”. Neurologic abnormalities of Lyme disease. Reik L; Steere AC; Bartenhagen NH; Shope RE; Malawista SE. Medicine, 58(4):281-94. 1979.

“Our patient showed a chronic and progressive clinical picture consisting of instability on walking and distal paresthesia of lower limbs, suggestive of posterior column disfunction.” Isolated posterior cord syndrome in Lyme disease: a clinico-neurophysiological study. Gutierrez MA; de Pablos C; Oterino A; Garcia Monco JC. Rev Neurol, 33(10):954-7. 2001.

“Weeks to years after the initial infection, behavioral changes, ataxia, and/or weakness in bulbar or peripheral muscles developed.” Central nervous system manifestations of Lyme disease. Pachner AR; Duray P; Steere AC. Archives of Neurology, 46(7):790-5. 1989

“We report the case of a 30-year-old man who developed severe dysphagia owing to neuroborreliosis. He showed dysphagia, diplopia, hiccups, and walking difficulty.” Rinsho Shinkeigaku. 2010 Apr;50(4):265-7. [Case of Borrelia brainstem encephalitis presenting with severe dysphagia]. Kawano Y, Shigeto H, Shiraishi Y, Ohyagi Y, Kira J. Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University.

“We present a case of a 4-year-old who presented to the emergency department with an unsteady gaitfor 2 days. Ataxia is a rare but known manifestation of cerebellar involvement in Lyme disease. Over the past 2 days, his gait had gotten progressively worse until he was unable to walk without assistance.”

Am J Emerg Med. 2008 Nov;26(9):1069.e5-6. Acute ataxia in a 4-year-old boy: a case of Lyme disease neuroborreliosis. Lopez MD, Wise C. Departments of Emergency Medicine and Pediatrics Medical College of Georgia, Augusta, CA 30912, USA.

“Our patient showed a chronic and progressive clinical picture consisting of instability on walking and distal paresthesia of lower limbs, suggestive of posterior column disfunction.” Rev Neurol. 2001 Nov 16-30;33(10):954-7.[Isolated posterior cord syndrome in Lyme s disease: a clinico neurophysiological study]. Gutiérrez MA, de Pablos C, Oterino A, García Moncó JC. Servicio de Neurofisiología Clínica; Hospital Universitario Marqués de Valdecilla, Santander, 39008, España.

“We report the case of a 21-year-old woman with a 12-day history of nausea and vomiting, gait and limbs ataxia, myoclonus, tremor of head and all four limbs, opsoclonus and cutaneous rash.” [Epstein Barr]. Arq Neuropsiquiatr. 2001 Sep;59(3-A):616-8. [Acute cerebellitis caused by Epstein-Barr virus: case report]. Teive HA, Zavala JA, Iwamoto FM, Bertucci-Filho D, Werneck LC. Serviço de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.

Additional Reading: Inflammatory brain changes in Lyme borreliosis: A report on three patients and review of literature. Oksi J; Kalimo H; Marttila RJ; Marjamaki M; Sonninen P; Nikoskelainen J; Viljanen MK. Brain, 119 ( Pt 6):2143-54. 1996.

Last Updated- April 2019

Lucy Barnes