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Lyme Disease (Lyme borreliosis,...
PEDIATRICS Vol. 112 No. 6 December 2003, pp. e477-e479

EXPERIENCE AND REASON

Lyme Disease Presenting With Persistent Headache

James M. Moses, MD, Robyn S. Riseberg, MD and Jonathan M. Mansbach, MD

From the Department of Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts

Increased intracranial pressure in patients with Lyme disease is an uncommon but reported finding. We discuss 2 patients from Lyme endemic areas who initially presented with headache, nausea, and vomiting and were eventually found to have increased intracranial pressure, a mild cerebrospinal fluid pleocytosis, and positive Lyme titers. It has been shown that increased intracranial pressure in association with neuroborreliosis can lead to blindness. In endemic areas, it is important for practitioners to consider Lyme disease when patients present with persistent headache, especially in those who have evidence of increased intracranial pressure.

Key Words: increased intracranial pressure • Lyme disease • persistent headache • neuroborreliosis

Abbreviations: CSF, cerebrospinal fluid • PCR, polymerase chain reaction • Ig, immunoglobulin

Received for publication May 9, 2003; Accepted Aug 11, 2003.