title: Lyme neuroborreliosis presenting as Alice in Wonderland syndrome.
abstract: We describe a 7-year-old boy with Alice in Wonderland syndrome associated with Lyme disease. He presented with metamorphopsia and auditory hallucinations in the absence of previous tick bites or other signs of Lyme disease. The boy never developed clinical seizures, and electroencephalograms during these spells indicated no epileptic activity. There was no history of migraine. Cranial magnetic resonance imaging produced normal results. Lyme serology tested positive in both serum and cerebrospinal fluid. He was treated with intravenous ceftriaxone for 3 weeks, with complete resolution of signs. This case report is the first, to our knowledge, of neuroborreliosis presenting as Alice in Wonderland syndrome with complete resolution of findings after intravenous antibiotic treatment.
authors.affiliation: Department of Pediatric Neurology, Floating Hospital for Children at Tufts Medical Center, Tufts University, Boston, Massachusetts 02111, USA. alsheikh55@yahoo.com
authors.forename: Ibrahim M
authors.initials: IM
authors.lastname: Binalsheikh
authors.forename: David
authors.initials: D
authors.lastname: Griesemer
authors.forename: Sonya
authors.initials: S
authors.lastname: Wang
authors.forename: Rebeca
authors.initials: R
authors.lastname: Alvarez-Altalef
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D025065:Borrelia burgdorferi; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone