Seizures associated with Lyme disease are treated via routine antiepileptic management principles.

Antibiotic treatment regimens for Lyme disease vary according to stage and differ for adults and children:

Lyme disease stage Treatment options
Erythema migrans and systemic symptoms
  • Amoxicillin 500 mg p.o. probenecid 500 mg t.i.d. 2–4 wks
  • Doxycycline 100 mg b.i.d. 2–4 wks
  • Cefuroxime 500 mg b.i.d.2–4 wks
  • Amoxicillin 25–50 mg/kg/day 2–4 wks
  • Erythromycin 30 mg/kg/day 2–4 wks
  • Cefuroxime 250 mg b.i.d.2–4 wks
Early neurologic involvement
  Facial palsy alone Oral antibiotics, same treatment as above
  All others
  • Ceftriaxone 2 g/day i.v 2–4 wks
  • Cefotaxime 2 g i.v. t.i.d.2–4 wks
  • Penicillin G 20 million U/day i.v.10–14 days
  • Doxycycline 100 mg p.o. b.i.d.2–4 wks
  • Ceftriaxone 75–100 mg/kg i.v. 2–4 wks
  • Penicillin G 300,000 U/kg/day i.v. 10–14 days
Late neurologic involvement
  • Penicillin, ceftriaxone, or cefotaxime i.v., same treatment as for early involvement
  • Doxycycline 100–200 mg p.o. b.i.d. 30 days
  • Penicillin or ceftriaxone i.v., same treatment as for early involvement


Antibiotic treatment regimens Table adapted from L Reik. Lyme Disease. In WM Scheld, RJ Whitley, DT Durack (eds), Infections of the Central Nervous System. Philadelphia: Lippincott–Raven, 1997;685–718; DW Rahn, MW Felz. Lyme disease update. Postgraduate Medicine 1998;103:51–70; JR Miller. Spirochete Infections: Lyme Disease. In LP Rowland (ed), Merritt’s Textbook of Neurology. Baltimore: Williams & Wilkins, 1995;209–211.
Adapted from: Goldstein MA and Harden CL. Infectious states. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;83-133.
With permission from Elsevier (

Reviewed By: 
Steven C. Schachter, MD
Monday, March 1, 2004