Lyme Neuroborreliosis in Children: 9 Cases and Key Symptoms

Lyme neuroborreliosis in children remains uncommon but clinically important. “The exact prevalence of Lyme neuroborreliosis in France is unknown because reporting is not required,” Guet-Revillet explains. “Nevertheless, the condition appears to be rare.”

Some children present with neurologic symptoms that resemble viral infections, delaying diagnosis.

The outcome for the nine children described in this case series was favorable following a two- to three-week course of third-generation cephalosporin therapy.

Range of Neurologic Presentations

Outcomes have not been uniformly positive in all pediatric cases. In their review, the authors describe rare but serious neurologic manifestations, including:

• Myoclonia
• Ataxia
• Vertigo
• Cranial polyneuritis (excluding isolated facial nerve palsy)
• Acute transverse myelitis
• Benign intracranial hypertension

Exceptional cases of acute disseminated encephalomyelitis and cerebrovascular complications, including stroke, have also been reported.

Diagnostic Challenges in Children

Diagnosing Lyme neuroborreliosis in children can be difficult. Clinical and laboratory findings often resemble viral meningitis, including infections caused by herpes simplex virus or varicella-zoster virus, as well as tuberculous meningitis.

These similarities, combined with delays in serologic testing, can complicate early diagnosis and treatment decisions.

Clinical Perspective

Although many pediatric cases respond well to treatment, variability in presentation and overlap with other neurologic conditions make careful evaluation essential.

Learn more about Lyme disease testing and diagnosis and why neurologic Lyme disease may be missed early.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention