Lyme Misdiagnosed as Conversion Disorder in Children

When Lyme is misdiagnosed as conversion disorder, children can lose months or years to symptoms that might have been treatable. I see this pattern regularly in my practice. This diagnostic error reflects one of the most damaging Lyme disease misconceptions in pediatric medicine.

She was fourteen when the tics started.

At first, her parents thought it was stress—ninth grade, new school, new pressures. But within weeks, the movements became constant. Her head jerked. Her hands trembled. She couldn’t hold a pencil. Words that once came easily now stuck somewhere between her brain and her mouth.

Then came the rage. She would scream at her parents over nothing, then collapse into tears, bewildered by her own behavior. She stopped sleeping. She stopped eating. She told her mother she didn’t feel like herself anymore—like something had taken over.

Her pediatrician referred her to neurology. The MRI was normal. The EEG was normal. Blood work showed nothing remarkable. She was referred to psychiatry, where she was diagnosed with conversion disorder. The explanation: her symptoms were real, but psychological in origin.

Six months later, after her symptoms had worsened and her parents had refused to stop searching, she tested positive for Lyme disease.

I see versions of this story regularly. The details differ—sometimes it’s a twelve-year-old boy with sudden OCD, sometimes a sixteen-year-old girl with dissociation and panic attacks—but the arc is almost always the same. A child develops sudden, frightening neuropsychiatric symptoms. Standard tests come back normal. A psychological diagnosis is offered. And somewhere along the way, Lyme disease is either never considered or ruled out too quickly.

When Lyme is misdiagnosed as conversion disorder, families lose trust, children lose time, and treatable illness is left to progress.

When Lyme Is Misdiagnosed as Conversion Disorder

Conversion disorder is a legitimate diagnosis—but when applied prematurely, before infectious or inflammatory causes have been explored, it can function as dismissal.

When laboratory tests are inconclusive and imaging appears normal, clinicians may feel pressure to provide an explanation. But “medically unexplained” does not mean “psychiatric by default.” Symptoms may be driven by infection, inflammation, or immune dysfunction in ways routine testing does not capture. When Lyme disease is excluded too early, the search for a treatable cause quietly stops. For more on dismissal patterns, see When Being Dismissed Hurts More Than the Illness.

Why Adolescents Are Vulnerable

A teenager who suddenly develops tics, intrusive thoughts, or emotional dysregulation is often referred directly to psychiatry. The assumption is reasonable: adolescence is emotionally turbulent, and psychiatric conditions often emerge in these years.

But that assumption can obscure another possibility—that the brain is inflamed, not merely stressed. This is how Lyme gets misdiagnosed as conversion disorder in practice—not through malice, but through premature closure.

PANS, PANDAS, and Tick-Borne Illness

Sudden neuropsychiatric symptoms in children are sometimes associated with PANS or PANDAS, classically linked to strep infection. However, Lyme disease and other tick-borne infections can produce nearly identical patterns.

Many patients I see with conversion disorder–like presentations are later found to have Lyme disease, Babesia, or Bartonella contributing to neuroinflammation. The overlap matters because it changes treatment—these children may need antibiotics or immune support, not just therapy.

For an overview, see my post on PANS and PANDAS in Lyme Disease.

Symptoms That Mimic Conversion Disorder

Neuropsychiatric Lyme disease may include:

• Panic attacks and severe anxiety
• Brain fog and slowed cognitive processing
• Emotional lability and rage episodes
• Dizziness, dissociation, or imbalance
• Abnormal movements, tics, or tremors
• Intrusive thoughts or sudden-onset OCD
• Personality changes that feel alien to the child and family

These symptoms often overlap with what is labeled conversion disorder—except they may be biologically driven and treatable.

The Cost for Families

The fourteen-year-old I described at the beginning? She lost a year.

A year of school she couldn’t attend. A year of friendships that drifted away. A year of her parents lying awake, wondering if they were failing her. A year of being told—directly and indirectly—that her suffering was not what it appeared to be.

Her mother told me, “I stopped trusting myself. Every time a doctor said it was anxiety, I thought maybe I was the problem.”

This is what happens when Lyme is misdiagnosed as conversion disorder. It doesn’t just delay treatment. It makes parents doubt their instincts. It makes children doubt their own experience.

I have watched parents weep in my office—not because the diagnosis was devastating, but because it was finally real. Because someone finally said: “This is not in her head. This is not your fault.”

These families are not looking for someone to blame. They want back the time they lost. And that, I cannot give them. What I can offer is a different path forward—and validation that they were right to keep searching. For more on pediatric presentations, see Pediatric Lyme Disease: Why Children Are Misdiagnosed.

What Clinicians Can Do Differently

• Include infectious and inflammatory causes in the differential for sudden neuropsychiatric symptoms
• Consider Lyme disease even when history is unclear
• Recognize that standard two-tier testing has limitations
• Use clinical judgment when tests are negative but presentation is suggestive
• Collaborate across psychiatry, neurology, and infectious disease

Listen Before You Label

Children cannot always advocate for themselves. They cannot always explain that their brain feels different, that their thoughts are not their own. When those symptoms are mistaken for anxiety or noncompliance, treatable illness is left to worsen.

If you are a parent still searching for answers: your instincts matter. Your observations are data. And your child deserves a clinician willing to stay curious.

Frequently Asked Questions

Can Lyme be misdiagnosed as conversion disorder? Yes. Neuropsychiatric symptoms of Lyme disease can closely resemble conversion disorder, especially when routine tests are normal.

Why are children more likely to be dismissed? Children often cannot articulate their symptoms clearly, and sudden behavioral changes may be attributed to stress or anxiety before infectious causes are considered.

What should I do if my child was diagnosed with conversion disorder but I suspect Lyme disease? Seek evaluation from a clinician experienced with tick-borne illness. A negative standard test does not rule out Lyme disease in all cases.

Can conversion disorder and Lyme disease occur together? Yes. Some patients may have functional symptoms alongside infection. One diagnosis does not exclude the other.

Related Reading (Dr. Daniel Cameron)

• Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases
• Neuropsychiatric Manifestations and Cognitive Decline in Patients With Long-Standing Lyme Disease: A Scoping Review
• Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections (PANDAS)
• PANS and PANDAS overview, Lyme Science blog, Dr. Daniel Cameron