I read this article here on our beloved lymenet...I cut and pasted some but would encourage you to read the full article above to see how prevalent and devastating and treatable this illness is in children...
God Bless this doc...I hope she is fighted back on the new guidelines
--------------------------------------- Neurologic Manifestations of Lyme in Children
The diagnosis of Lyme Disease is a clinical one. The serology, if positive, is helpful. We consider a positive serology as a 1:128 IFA; ELISA that is greater than .79. Urine antigens can also be measured. The tests on urine antigens are still considered investigational.
We will treat patients with negative serologies without hesitation if they truly have a number of the symptoms and are incapacitated by them. We have had children who have been out of school for an entire year because they have been too sick to leave the house.
Other children have had to give up all extracurricular activities, sports, etc. because they are too sick and too weak to participate. Every patient we have treated with the diagnosis of Neurologic Lyme Disease has had persistent complaints. These children have a headache and frequently chest pain. Many of them have seen numerous doctors without any specific diagnosis being made and many of them have had antibiotics for various reasons along the way, sore throats, otitis media, rash and, therefore, never developed an antibody response to their spirochetal infection.
The diagnosis of Neurologic Lyme Disease is a clinical one, not a laboratory one. If the patient's symptoms are compatible with the diagnosis, the patient is ill, the disease is having a significant effect on the person's ability to function, then they deserve treatment. I believe it is safer to be aggressive and treat someone under those circumstances than to allow them to continue suffering indefinitely.
(A few case studies from the article....go to above link to read them all)
A two year old little girl whose parents felt she had become excessively irritable was seen. She had a diaper rash that responded to no treatment that the pediatrician had prescribed. Because of her exposure to field mice and the fact that they do carry the tick, her parents insisted on a Lyme titer which was positive - 1:512. Because she was irritable and because of the persistent rash, she was given fourteen days of ceftriaxone with dramatic improvement in her behavior. The rash cleared and never returned.
A six year old girl was seen in September, 1987 with a very mild left facial weakness. She does not recall a tick bite but had exposure to ticks. She lives in a wooded area. Her Lyme titer was positive - 1:128. Her spinal fluid protein was 137 mgs. with no cells and a glucose of 63. Because of the mild left facial weakness and also headache, she was treated for Lyme and responded and did well. She received two courses of treatment for a total of twenty-eight days of ceftriaxone.
A sixteen year old boy who woke up with bilateral facial palsy was seen. He was unable to talk and unable to eat. Also had headache. He had been bitten by ticks. Lyme titer was 1:128. He was given twenty-one days of intravenous ceftriaxone with a dramatic improvement and an unremarkable neurologic examination four weeks after the initiation of the treatment. In addition to the ceftriaxone, he was also given Prednisone.
A nine year old girl was seen in 1985 initially complaining of headache, joint pain and photophobia. Spinal fluid: opening pressure was 230, 13 cells and a protein of 50. Titer was 1:256. Treated initially with aqueous penicillin. Retreated with ceftriaxone. Has been treated again in 1986, 1987 and 1988. She has persistently abnormal electroencephalograms and a significant fall-off in school performance. She now requires remedial help. She continues to have occasional headaches and joint pain. She continues to have abnormal EEG's and a persistently positive Lyme titer - 1:256. She will probably require more treatment.
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