Lyme Meningoencephalitis Masquerading as Normal Pressure Hydrocephalus

Lyme disease is a tick-borne illness caused primarily by the spirochete Borrelia burgdorferi. The disease is most prevalent in forested areas endemic for Ixodes tick, which transmits the spirochete. Here, we describe a case of Lyme meningoencephalitis masquerading as normal pressure hydrocephalus (NPH) which initially presented with urinary incontinence, gait instability, and neurological decline. Due to its non-specific symptoms and low incidence, Lyme meningoencephalitis causing NPH like syndrome poses a diagnostic conundrum for clinicians. Awareness of this disease entity is key for prompt diagnosis and treatment.