Lyme disease (LYD) is a multisystemic illness caused by the
tick-borne spirochete Borrelia burgdorferi (Bb). LYD, the most
common tick-borne illness in the United States,1 may manifest in
a variety of ways: dermatologic, arthritic, ophthalmologic,
cardiac, and neuropsychiatric.2 The incidence and spread of the
disease increased during the 1980s,3 stabilizing somewhat in the
late 1990s. Children below the age of 9 are at a high risk for
Bb infection,4 with many new cases of Lyme occurring among
persons younger than 14 years.5 The neuropsychiatric symptoms of
LYD in adults have been described,6,7 but little has been
published about the neuropsychiatric effect of the disease in
children and adolescents. In adults, deficits in attention and
memory have been reported.8,9 In children, a controlled study of
cognitive symptoms investigated a sample of all children and
adolescents who presented to a LYD clinic, most of whom
presented with rheumatological symptoms, had been diagnosed
early, and had been treated appropr