Lyme disease triggers seizures in young child

In their article, “Rare Presentation of Pediatric Nervous System Lyme Disease: A Case Report,” Khurtsilava and colleagues describe a unique case involving a young child who developed seizures due to Lyme disease. [1]

Nervous system Lyme disease has a wide spectrum of manifestations, including facial nerve palsy and subacute meningitis, which are often observed in the pediatric population, the authors state. But only rarely, have cases of seizures triggered by Lyme disease been reported.

In their case report, the authors describe a 4-year-old boy who was admitted to a clinic in Tbilisi, Georgia after exhibiting generalized tonic-clonic seizures that did not improve with one dose of diazepam therapy.

During the previous 2 days, the child developed increased fatigue, refused to walk, had two instances of falling and lost consciousness three times.

“The morning of the presentation, the child woke up feeling lethargic, followed by tonic-clonic seizures, and loss of awareness.”

Clinicians diagnosed the child with status epilepticus and he was subsequently intubated and prescribed IV midazolam.

However, EEG testing later revealed no epileptic patterns and no apparent cause was identified for the seizures.

The antibiotic Ceftriaxone was prescribed, along with acyclovir, which was discontinued after test results were negative for the herpes simplex virus.

Could Lyme disease trigger seizures in the young child?

“Despite non-classical manifestations, Lyme disease was considered,” the authors state. Subsequently, the child tested positive for Lyme disease and began treatment with doxycycline.

“Upon discussing the results with the parents, they recalled noticing a rash four months ago, which resolved on its own,” the authors state.

One month after treatment, the child exhibited mood changes and sleep disorders with night terrors.

“The mother reported the presence of imaginary friends and anxiety,” the authors state.

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

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

Authors Conclude:

• “We believe that this case underscores the importance of considering Lyme borreliosis in the differential diagnosis when complex neurological symptoms arise in pediatric patients.”
• “The awareness of uncommon clinical manifestations in pediatric patients with Lyme neuroborreliosis is crucial for clinicians to successfully diagnose and treat the disease.”
• “The prolonged post-treatment behavioral problems raise questions about the potential long-term effects of neuroborreliosis and show the need for continued research into a comprehensive understanding of Lyme disease in pediatric patients.”