Lyme Disease Seizures in Children: A Rare but Serious Sign

A mother watched her 4-year-old convulse and lose consciousness. No warning. No fever. No explanation. When the seizures didn’t stop with medication, he was intubated. Doctors scrambled for answers—but the real cause wouldn’t be discovered for days.

His diagnosis? Lyme disease.

Lyme disease seizures in children are rare, but this case from Tbilisi, Georgia reminds us that tick-borne illness can present in ways that don’t look like Lyme at all. When a child develops unexplained neurological symptoms, Lyme disease deserves a place on the differential—even when it seems unlikely.

Who This Page Is For

This resource is for parents whose children have experienced unexplained seizures, families searching for answers after neurological symptoms appeared without cause, and clinicians considering atypical presentations of tick-borne illness. If your child has been dismissed or told “we don’t know why this happened,” this page is for you.

The Case: A 4-Year-Old With Status Epilepticus

In a recent case report published by Khurtsilava and colleagues, researchers describe a 4-year-old boy admitted to a clinic in Tbilisi, Georgia after exhibiting generalized tonic-clonic seizures. One dose of diazepam didn’t stop them.

In the two days before admission, the child had developed increased fatigue, refused to walk, fell twice, and lost consciousness three times. The morning of his presentation, he woke up lethargic—then the seizures began.

Clinicians diagnosed status epilepticus and intubated him. They prescribed IV midazolam to control the seizures.

But EEG testing revealed no epileptic patterns. No apparent cause could be identified.

The medical team prescribed ceftriaxone and acyclovir, but discontinued the antiviral after testing came back negative for herpes simplex virus. They were searching—but still hadn’t found the answer.

When Lyme Disease Was Finally Considered

Lyme disease seizures in children are not a classic presentation. Nervous system Lyme disease more commonly causes facial nerve palsy or subacute meningitis in pediatric patients. Seizures? Rarely reported.

But the medical team didn’t stop looking.

“Despite non-classical manifestations, Lyme disease was considered,” the authors state.

The child tested positive. Treatment with doxycycline began.

Only then did his parents recall something important: four months earlier, they had noticed a rash on their son. It had resolved on its own. No one connected it to his current crisis.

This is how Lyme disease misdiagnosis in children happens. Most children with Lyme never recall a tick bite. Rashes fade. Symptoms appear months later in forms that don’t look like the textbook.

Post-Treatment: The Symptoms Didn’t End There

One month after treatment, the child exhibited mood changes and sleep disorders with night terrors. His mother reported the presence of imaginary friends and anxiety.

Four months after the initial diagnosis, severe behavioral problems persisted—frequent tantrums, screaming, and hallucinations.

The child received psychiatric care. These symptoms gradually resolved after six months, with only mild mood swings still present.

This pattern—neurological symptoms followed by prolonged behavioral and cognitive issues—is something I see in my practice. It raises important questions about the long-term effects of neuroborreliosis in children and underscores why managing Lyme in children requires more than antibiotics alone.

What This Case Teaches Us

The authors draw several important conclusions from this case of Lyme disease seizures in children.

First, Lyme borreliosis belongs in the differential diagnosis when complex neurological symptoms arise in pediatric patients—even when the presentation is atypical. Seizures aren’t what most clinicians expect from Lyme, which is precisely why they get missed.

Second, awareness of uncommon clinical manifestations is crucial for successful diagnosis and treatment. If the medical team hadn’t considered Lyme despite the unusual presentation, this child might still be searching for answers.

Third, the prolonged post-treatment behavioral problems raise questions about potential long-term effects of neuroborreliosis. This case shows the need for continued research into a comprehensive understanding of Lyme disease in pediatric patients—and the importance of long-term follow-up during recovery.

Red Flags for Neurological Lyme in Children

Lyme disease seizures in children are rare, but other neurological signs may appear. Parents and clinicians should watch for:

Facial weakness or drooping, which may indicate facial nerve palsy—one of the more common neurological presentations of pediatric Lyme. Severe headaches with neck stiffness could suggest meningitis. Brain fog, memory problems, or confusion in a previously sharp child deserve investigation. Sudden behavioral changes, mood swings, or psychiatric symptoms—especially when they appear abruptly—may have an infectious trigger. And yes, unexplained seizures or altered mental status, though rare, can be caused by Lyme disease.

Any of these symptoms in a child with possible tick exposure—or even without known exposure—warrants consideration of tick-borne illness.

Frequently Asked Questions

Can Lyme disease cause seizures in children?

Yes, though it’s rare. Lyme disease seizures in children have been documented in case reports. When a child presents with unexplained seizures and no clear cause is found, Lyme disease should be considered—especially in endemic areas or with possible tick exposure.

Why are Lyme disease seizures in children often missed?

Because seizures aren’t a classic Lyme symptom. Clinicians typically expect rash, joint pain, or facial palsy. When symptoms don’t fit the textbook, Lyme drops off the radar—even when it’s the underlying cause.

What should I do if my child had seizures and no cause was found?

Ask about Lyme disease testing. Be aware that standard tests have limitations and may miss early or neurological Lyme. A clinical evaluation by a physician experienced in tick-borne illness may be warranted.

Can children have lasting symptoms after Lyme treatment?

Yes. As this case shows, behavioral and cognitive symptoms can persist for months after treatment. Comprehensive care and long-term follow-up are essential for supporting full recovery.

How can I protect my child from Lyme disease?

Tick bite prevention is key—though not always possible. Tick checks, prompt removal, and awareness of symptoms can help catch infection early. Treatment is most effective when started promptly.

The Bottom Line

Lyme disease seizures in children are rare—but this case reminds us that Lyme can present in ways that don’t look like Lyme. A 4-year-old with status epilepticus. No tick bite recalled. No rash at presentation. And yet, Lyme disease was the cause.

When complex neurological symptoms arise in a child without clear explanation, Lyme deserves consideration. The prolonged behavioral symptoms that followed this child’s diagnosis also underscore why recovery requires more than antibiotics—and why ongoing research into pediatric neuroborreliosis matters.

If your child has unexplained neurological or behavioral symptoms, don’t stop asking questions.

“Lyme disease seizures in children are rare, but when standard explanations fail, Lyme disease deserves a place on the list.”

Related Reading

• Lyme Disease Misdiagnosis in Children: One Family’s Story
• Managing Lyme in Children: 12 Interventions I Use
• Children and Lyme Disease: Why Most Never See a Tick Bite
• Medical Dismissal and Lyme Disease
• Brain Fog and Cognitive Symptoms
• Lyme Disease Recovery and PTLDS
• Lyme Disease Treatment Options
• Lyme Test Accuracy: Why Results Can Mislead
• Can Lyme disease cause seizures?
• Seizures and altered mental status after Lyme disease