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Updated: May 12, 2026

Feeding of Ticks on Animals for Transmission and Xenodiagnosis in Lyme Disease Research
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Lyme Disease and Papilledema: A Retrospective Study on Clinical Characteristics and Outcomes

Joseph Vithayathil1,2, Akash Virupakshaiah3, Geraldine Liu1

  • 1Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Journal of Child Neurology
|September 2, 2024
PubMed

Insights

Children with Lyme disease and papilledema often recover fully with antibiotic treatment, even with cerebrospinal fluid pleocytosis. Most cases show resolution without lasting deficits.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Papilledema, or swelling of the optic disc, can be a serious complication in pediatric patients.
  • Lyme disease, a tick-borne illness, can present with various neurological manifestations.

Purpose of the Study:

  • To describe the clinical features, treatments, and outcomes of pediatric patients diagnosed with both papilledema and Lyme disease.
  • To analyze the relationship between cerebrospinal fluid findings and treatment response.

Main Methods:

  • A retrospective cohort study was conducted involving children aged 1-18 years diagnosed with papilledema and Lyme disease between 1995 and 2019.
  • Data were collected through medical record abstraction and family surveys.

Main Results:

  • Of 44 children, 66% had cranial neuropathies and 78% had cerebrospinal fluid (CSF) pleocytosis. All received antibiotics, and 61% also received acetazolamide.
  • Eighty-six percent of children with follow-up data experienced full symptom resolution.
  • Recovery rates did not significantly differ based on antibiotic route or CSF pleocytosis.

Conclusions:

  • Papilledema in pediatric Lyme disease can occur with or without CSF pleocytosis.
  • The majority of children achieve full recovery without residual deficits following appropriate treatment.
  • Exceptions to full recovery exist, highlighting the need for continued monitoring.
Abstract

Keywords:
intracranial hypertensionneuroophthalmologypediatric

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