Residual orofacial complaints following Lyme neuroborreliosis: an unusual case of TMD

Patients with tick-borne Lyme neuroborreliosis (LNB) can present with a variety of symptoms, and frequently the oral and maxillofacial areas are affected. Even though treatment with antibiotics generally results in a remission of symptoms, patients with permanent nerve damage may show residual symptoms. This case report describes a 61-year-old Caucasian woman, who was referred by a neurologist for residual LNB-induced pain in the face and impaired movement of the mandible. Since these signs and symptoms resembled those of temporomandibular disorders (TMD), the patient received physical therapy, ie, intra-oral massage and mobilization exercises. Three months later, the myofascial pain had diminished, and the mouth opening had increased. It was concluded that dentists play an active role in the management and/or referral of patients with residual LNB complaints in the orofacial area. In addition, a concise overview is presented of the clinical manifestations, diagnosis, and treatment outcome of LNB.