My brother got it (works backwoods in western MA), but was lucky enough to recognize the bulls-eye around bite, and got the antibiotics right away. Unfortunately, most victims don't get a clear bulls-eye.
Symptoms are highly varied, depending on stage -- even Bell's Palsy (incl. facial paralysis). It's a long list -- checkhttp://www.medicinenet.com/lyme_disease/article.htm
If it goes really far, folks can be on an antibiotic drip for months. I've known 2 who got that far (2nd-hand).
Out west, the vectors seem more varied than back east.