by Marian Rissenberg, Ph.D. & Susan Chambers, M.D.
1) Diffuse cerebral diffusion abnormalities
2) Alterations in cellular metabloism at the cortical level
3) Neuro transmitter abnormalities
4) Neurotoxic substances
As with a head injury, the patient may "look fine" though they are having difficulty with very basic work, social and day to day functioning.
See article "Distinct pattern of cognitive impairment noted in study of Lyme patients"