Table 4.

Scholarship related to LD or tick-borne disease and seizures appears in individual case reports more frequently than population studies. Official recognition by the CDC of seizures in tick-borne disease are noted only in Powassan virus disease and tick-borne encephalitis virus (TBE).

Progressive inflammatory reactions are related to seizure activity. In LD, a psychoimmune process is associated with psychiatric symptoms in LD patients. “Borrelia burgdorferi infections have been associated with the proinflammatory cytokines IL-6, IL-8, IL-12, IL-18 and interferon g, the chemokines CXCL12 and CXCL13 and increased levels proinflammatory lipoproteins”.	[65]
There was a case report of a patient presenting with Lyme cerebral vasculitis and grand mal seizures. Stroke and stroke-like syndromes can also be associated with LD.	[66]
Comorbidities result from immune and metabolic effects as LD progresses, leading to the gradual development of a host of neuropsychiatric symptoms. These can include seizures, depersonalization, suicide, anxiety disorders, eating disorders, depression, autism spectrum disorders, and other neuropsychiatric sequelae.	[67]
A previously healthy 13-year-old boy presented with seizures. Through serological testing, the patient was diagnosed with neuroborreliosis and improved with three weeks of ceftriaxone.	[68]
In death certificates with LD as the underlying cause of death, there was one report of a seizure disorder being the terminal event.	[69]
A case report of an 18-year-old male presenting with seizures and a headache had a positive serum analysis for PVD.	[48]
The Centers for Disease Control and Prevention recognize seizures as a symptom in PVD and tick-borne encephalitis virus.	[27]