title: Lyme disease presenting with persistent headache.
abstract: 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.
authors.affiliation: Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 32115, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Moses
authors.forename: Robyn S
authors.initials: RS
authors.lastname: Riseberg
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Mansbach
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D007427:Intracranial Pressure; D007964:Leukocytosis / Q000134:cerebrospinal fluid; D008193:Lyme Disease / Q000150:complications / Q000175:diagnosis*; D009325:Nausea; D009901:Optic Nerve Diseases / Q000209:etiology*; D014839:Vomiting