Lyme Disease Symptoms

In each box below enter the number that corresponds with your choice. (0 = Never, 1 = Occasionally, 2 = Often, 3 = Regularly).

Please note some questions in this section may have different scoring which will be written next to it in the following format (0=Never, 2 ou 4=Occasionally,4 ou 6= Often, 6 ou 8=Regularly).

Arthritis-like joint pain or swelling (0,2,4,6)

Stiff neck (0,2,4,6)

Pain migrates or moves around to different areas? (0,2,4,6)

Twitching of facial or other muscles

Forgetfulness or poor short-term memory (0,2,4,6)

Muscle pain or cramps

Confusion, difficulty thinking

Costochondritis (sternum/breastbone and rib junction pain) (0,4,6,8)

Disorientation (getting lost; going to wrong places)

Right shoulder pain (AC joint)

Difficulty with speech or writing (0,4,6,8)

Facial paralysis (Bell's palsy) (0,4,6,8)

Tingling, numbness, burning, or stabbing sensations (0,4,6,8)

Unexplained menstrual irregularity (0,4,6,8)

Disturbed sleep: too much, too little, early awakening (0,2,4,6)

Unexplained breast milk production (0,4,6,8)

Unexplained fevers, sweats, chills, or flushing

Irritable bladder or bladder dysfunction (0,4,6,8)

Unexplained weight change (loss or gain)

Sexual dysfunction or low libido (0,4,6,8)

Difficulty swallowing

Blurry or double vision

Fatigue, lack of energy

Ear buzzing, ringing, or pain

Sore throat or swollen glands

Vertigo or increased motion sickness (0,4,6,8)

Pelvic or testicular pain (0,4,6,8)

Light-headedness, poor balance, difficulty walking (0,4,6,8)

Crepitus (joing cracking) (0,4,6,8)

Hallucinations, paranoia, or schizophrenia (0,2,4,6)

Woozy (mentally unclear or hazy) (0,2,4,6)

Panic attacks

Tremors (0,2,4,6)

Eating disorder (0,4,6,8)

Headaches

Pulse skips (0,4,6,8)

Impulsivity, aggression, or bipolar

Gastrointestinal problems (0,4,6,8)

Depression

Change in bowel function (0,4,6,8)

Skin hypersensitivity (0,2,4,6)

Exaggerated symptoms or worse hangover from alcohol (0,4,6,8)

Lyme Disease Symptoms Total:-_____________

Risk for Lyme Disease Symptoms:

Low = 0-31, Medium = 32-95, High =96-238