Long-Term Cognitive Effects of Lyme Disease in Children

Abstract

Most studies of adults infected with Lyme disease (LD) have found adverse cognitive effects from the disease. In contrast, the only controlled study investigating cognitive effects of LD in a pediatric population found no effects after a 2-year follow-up. However, it was questioned whether the negative effects might take longer than 2 years to emerge. Therefore, this investigation reports a 4-year follow-up of the original sample. Twenty-five children with strictly defined LD were compared with 17 sibling control children. A neuropsychological battery was utilized, including assessment of the cognitive areas of IQ, information processing speed, fine-motor dexterity, novel problem solving and executive functioning, short-term and intermediate memory, and acquisition of new learning. In addition, parents' subjective ratings were obtained on the disease's impact on their child's participation in everyday activities. No between-group differences were found for 17 of the 18 neuropsychological test measures, nor were there differences in parents' subjective ratings. Therefore, in contrast with studies of adults with LD, the results of long-term follow-up of the pediatric population continue to strongly support the finding that children treated appropriately for LD have an excellent prognosis for normal cognitive functioning.

Chronic Lyme Disease: A Review

“…The appearance of post-Lyme disease symptoms seems to correlate with disseminated disease, a greater severity of illness at presentation, and delayed antibiotic therapy [12,[29][30][31][32][33]; but not with the duration of the initial antibiotic therapy [13,23]. Children appear to be less likely to develop post-Lyme disease symptoms [34][35][36][37][38][39][40][41][42].…”

Lyme Arthritis

“…Arthralgias in joints previously affected by arthritis may persist for several months but usually do not restrict the physical or educational performance of adolescents. Late neurologic complications occurred in untreated children with Lyme arthritis (Szer et al, 1991) but have not been found after appropriate treatment (Adams et al, 1994). However, transient neurocognitive abnormalities have been described (Bloom et al, 1998).…”

Lyme-Arthritis bei Kindern und Jugendlichen

“…Die Prognose von Kindern mit Erythema migrans oder früher Neuroborreliose ist exzellent, wenn die Erkrankung rasch mit den empfohlenen Antibiotika behandelt wird [69,76,77,78]. Sogar Kinder mit Lyme-Arthritis, die nicht antibiotisch behandelt wurden, zeigen eine Verminderung und ein Verschwinden der Symptome mit der Zeit [79].…”

“…Arthralgien in vorher arthritischen Gelenken können über Monate persistieren, aber bei Kindern kommt es meist nicht zu einer Fibromyalgie. Späte neurologische Komplikationen sind bei nicht antibiotisch behandelten Kindern beschrieben [79], nicht aber nach angemessener antibiotischer Behandlung [81]. Vorübergehende neurokognitive Auffäl-ligkeiten sind hingegen beschrieben [82].…”