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[Acute myelitis and Lyme disease]

F Blanc1, S Froelich, F Vuillemet

  • 1Département de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg. Frederic.Blanc@chru-strasbourg.fr

Revue Neurologique
|November 23, 2007
PubMed
Abstract

Insights

Acute Lyme myelitis, a rare form of neuroborreliosis, presents diverse clinical and imaging features. Early Lyme serology in cerebrospinal fluid (CSF) is crucial for diagnosing acute myelitis, especially in endemic regions.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Acute myelitis constitutes 4-5% of neuroborreliosis cases.
  • Simultaneous spinal MRI and CSF investigations are rarely reported.
  • This study details three cases of acute Lyme myelitis.

Observation:

  • Patients presented with motor, sensory, and sphincter dysfunction.
  • Extra-spinal symptoms included fever, headache, facial nerve palsy, and subarachnoid hemorrhage.
  • Spinal cord MRI showed extensive lesions (>3 vertebral segments).

Findings:

  • CSF analysis revealed pleocytosis and positive Lyme serology in all patients.
  • Intrathecal anti-Borrelia antibody index was positive or intermediate.
  • Myelitis patterns varied: central, posterior, or transverse.

Implications:

  • Lyme myelitis exhibits diverse clinical and radiological manifestations.
  • CSF Lyme serology is essential for diagnosing acute myelitis in endemic areas.
  • Prompt antibiotic treatment led to favorable clinical outcomes.

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