Can Lyme Disease Cause Seizures in Children?
Can Lyme disease cause seizures in children? In rare but serious cases, the answer is yes.
Lyme disease seizures in children can occur when infection affects the brain and nervous system, triggering inflammation that disrupts normal neurologic function.
In this case, a 4-year-old boy developed life-threatening seizures without fever, without warning, and without a clear cause.
His story highlights how pediatric Lyme neuroborreliosis can present in unexpected ways—and how easily the diagnosis can be missed.
Neurologic complications like seizures represent one of the more severe patterns described in the broader Lyme Disease Symptoms Guide.
A 4-Year-Old Boy Develops Status Epilepticus
In a case report published in Cureus, Khurtsilava and colleagues describe a 4-year-old boy admitted to a clinic in Tbilisi, Georgia after developing generalized tonic-clonic seizures that did not improve with diazepam therapy.
During the previous two days, the child developed increasing fatigue, refused to walk, fell twice, 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,” the authors wrote.
Clinicians diagnosed status epilepticus and intubated the child. IV midazolam was prescribed to control the seizures.
However, EEG testing later revealed no epileptic patterns, and no clear cause for the seizures was identified. The medical team prescribed ceftriaxone along with acyclovir, though the antiviral medication was discontinued after herpes simplex virus testing returned negative.
When Lyme Disease Was Finally Considered
Nervous system Lyme disease most commonly presents in children with facial nerve palsy or subacute meningitis. Seizures are rarely reported.
However, Lyme neuroborreliosis can occasionally trigger severe neurologic inflammation involving the central nervous system.
“Despite non-classical manifestations, Lyme disease was considered,” the authors explained. The child subsequently tested positive for Lyme disease and began treatment with doxycycline.
Only afterward did the parents recall noticing a rash four months earlier that had resolved on its own.
This is one reason Lyme disease is often missed in children. Tick bites frequently go unnoticed. Rashes disappear. Symptoms may emerge months later in forms that do not resemble classic Lyme disease.
Behavioral and Psychiatric Symptoms Persisted
One month after treatment, the child developed mood changes and sleep disturbances with night terrors.
“The mother reported the presence of imaginary friends and anxiety,” the authors noted.
Four months after diagnosis, severe behavioral symptoms persisted, including tantrums, screaming, and hallucinations. The child eventually required psychiatric care.
Over the following six months, symptoms gradually improved, although mild mood swings remained.
This prolonged recovery raises important questions about the potential long-term neurologic and behavioral effects of pediatric neuroborreliosis.
What This Case Teaches Us
This case highlights the importance of considering Lyme disease when unexplained neurologic symptoms occur in children, even when the presentation is atypical.
Uncommon neurologic presentations are easily overlooked because they do not fit textbook expectations. Delayed diagnosis can lead to severe complications, and recovery may extend beyond infection treatment itself.
The authors concluded that clinicians should consider Lyme borreliosis in the differential diagnosis when complex neurologic symptoms arise in pediatric patients.
Frequently Asked Questions
Can Lyme disease cause seizures in children?
Yes. Although rare, Lyme neuroborreliosis has been associated with seizures and status epilepticus in pediatric case reports.
Why are Lyme-related seizures often missed?
Seizures are not considered a classic Lyme presentation, so clinicians may initially search for other neurologic causes.
Can Lyme disease cause psychiatric symptoms in children?
Neurologic Lyme disease may occasionally be associated with mood changes, anxiety, sleep disturbances, hallucinations, or behavioral symptoms.
What is pediatric Lyme neuroborreliosis?
It refers to Lyme disease affecting the nervous system in children, potentially involving the brain, meninges, cranial nerves, or spinal cord.
Clinical Takeaway
Lyme disease can rarely trigger severe neurologic complications in children, including seizures and status epilepticus. When unexplained neurologic symptoms arise, Lyme disease should remain in the differential diagnosis even when classic symptoms are absent.
Early recognition may be life-saving.
Related Articles
Can Lyme Disease Cause Seizures?
Seizures and Altered Mental Status After Lyme Disease
Autism Symptoms Improve Following Treatment for Lyme Disease
Pediatric Lyme Disease
References
- Khurtsilava I, Kanjaradze D, Tsirdava N, et al. Rare Presentation of Pediatric Nervous System Lyme Disease: A Case Report. Cureus. 2024;16(5):e60535. doi:10.7759/cureus.60535
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
