Steven G. Pavlakis, MD Director, Pediatric Neurology and Development explains the facts about Lyme Disease and Headaches
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Male1: It is spring now and things are blooming and you hear a lot about Lyme disease and occasionally, you actually see a patient with Lyme disease because they sometimes present with headaches, is that true? Male2: Yes, sometimes, Lyme disease can present with headaches, however, the only time that knowingly, I have seen Lyme disease with headaches, the patient also had other signs and symptoms of Lyme disease that that being a rash or a tick bite or arthritis. I have never seen a patient that we knew had Lyme disease and of course, we do not always check it, unless we have other signs or symptoms that have an acute onset of headache without any other signs or symptoms. Male1: If they have a headache, is that a sign of a very bad version of Lyme disease? Male2: Not necessarily and I do not—this has not really been well worked out either, but the patients that I have seen with headaches, a great majority with Lyme Disease tend to have simple Lyme disease or just first or second stages. Male1: Usually, the headache usually goes away when the treatment is successful? Male2: Correct, when the patient is started on antibiotics the headache goes away and the signs and symptoms go away and the child is fine. Male1: And if it does persist, it could be a little bit red flag, the headache might be caused by something else that should be looked into? Male2: Either by something else or whether there is—Lyme disease can go to the central nervous system, we do know that it can, but it is pretty rare. Atleast in children, so if it persists, it would still be Lyme Disease, but it will be in the central nervous system so that is possible. Male1: So they always get down, always watch and if you go to a good doctor, make sure, he evaluates, is that correct? Male2: I think that is right and you cannot go looking for all of these rare things right upfront. You have to watch the patient that if the child does well and has a typical course, and gets better on penicillin, you live longer— Male1: But it is going to be in the news and they take the signs and symptoms and there is Lyme Disease and they see the one with the headache, half my practice have got a thing, I have got to look for Lyme disease, without anything else, it is not number one and it less sporadic, is that true? Male2; That is correct, it is probably number 50th. If not below that, but there is very little indication for doing that that is right.

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