Tick-borne illness has become one of the most underrecognized confounders in clinical neurology. With CDC-reported Lyme disease cases rising steadily each year and nearly one in four ticks carrying additional pathogens, the intersection of Lyme neuroborreliosis and chronic post-concussive syndrome represents an emerging and critical area of clinical competency. Functional neurologists treating complex TBI cases must now consider whether persistent symptoms reflect not only neural injury, but also an active or subclinical infectious process driving ongoing neuroinflammation.

This course equips clinicians with a research-grounded framework for identifying Lyme disease and associated co-infections in patients with chronic post-concussive syndrome. Participants will examine the shared neuropsychiatric and neurological symptom profiles of neuroborreliosis and mild TBI, explore the immunological mechanisms through which traumatic brain injury may unmask or amplify subclinical Lyme infection, and learn how microglial priming and blood-brain barrier compromise create the conditions for persistent CNS inflammation. The course also addresses the significant limitations of standard Lyme testing through LabCorp, Quest, and comparable platforms, and introduces more sensitive diagnostic considerations including co-infection panels for Babesia, Bartonella, Ehrlichia, and tick-borne relapsing fever. Clinical markers such as cutaneous Bartonella lesions and histamine-response findings during physical examination are discussed as low-cost, high-yield observational tools.

This course is designed for licensed chiropractors, chiropractic neurologists, functional neurologists, and integrative clinicians who regularly evaluate patients with persistent post-concussive symptoms and are seeking a more complete diagnostic picture. It is particularly relevant for clinicians practicing in Lyme-endemic regions or seeing patients who have failed to progress despite high-quality neurological rehabilitation.

Dr. Sergio Azzolino is a board-certified chiropractic neurologist, diplomate and fellow in neurology, and president of the American Chiropractic Neurology Board. A faculty member of the Carrick Institute and a graduate of Harvard Medical School's Global Clinical Scholars Research Program, Dr. Azzolino brings nearly three decades of clinical experience and published peer-reviewed research to this presentation, including a retrospective study of 217 post-concussive patients examining Lyme prevalence that found a 37.68% IgM positivity rate in a chronic symptom population.