Underdiagnosis of Lyme

Psychiatr Clin North Am. 1998 Sep;21(3):693-703, viii.

The underdiagnosis of neuropsychiatric Lyme disease in children and adults.

Fallon BA, Kochevar JM, Gaito A, Nields JA. Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.

Lyme Disease has been called "The New Great Imitator," a replacement for that old "great imitator" neurosyphilis. This article reviews the numerous psychiatric and neurologic presentations found in adults and children. It then reviews the features of Lyme Disease, which makes it almost uniquely hard to diagnose, including the complexity and unreliability of serologic tests. Clinical examples follow that illustrate those presentations of this disease that mimic attention deficit hyperactivity disorder (ADHD), depression, and multiple sclerosis.