The underdiagnosis of neuropsychiatric Lyme disease in children and adults.
Lyme Disease has been called "The New Great Imitator," a replacement for that old "great imitator" neurosyphilis. This article reviews the numerous psychiatric and neurologic presentations found in adults and children. It then reviews the features of Lyme Disease, which makes it almost uniquely hard to diagnose, including the complexity and unreliability of serologic tests. Clinical examples follow that illustrate those presentations of this disease that mimic attention deficit hyperactivity disorder (ADHD), depression, and multiple sclerosis.
Fallon
B A
BA
Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.
Kochevar
J M
JM
Gaito
A
A
Nields
J A
JA
D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis; D015153:Blotting, Western / Q000592:standards; D015748:Borrelia burgdorferi Group / Q000472:pathogenicity; D002648:Child; D003863:Depression / Q000175:diagnosis; D003937:Diagnosis, Differential; D004675:Encephalitis, Tick-Borne / Q000175:diagnosis; D004679:Encephalomyelitis / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000628:therapy; D016920:Meningitis, Bacterial / Q000175:diagnosis; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012698:Serologic Tests / Q000592:standards