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[Recurrent ischemic strokes revealing Lyme meningovascularitis]
1Département de neurologie, hôpital Civil, hôpitaux universitaires, 1, place de l'Hôpital, 6700 Strasbourg, France.
Revue Neurologique
|September 2, 2008
Summary
Lyme neuroborreliosis can cause ischemic stroke (IS) and multiple intracranial stenosis. Early diagnosis and antibiotic treatment are crucial for managing this rare complication in endemic areas.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Neurology
Background:
- Infectious vascularitis is an uncommon etiology for ischemic stroke (IS).
- Lyme neuroborreliosis, a tick-borne illness, can manifest with neurological complications.
- This case highlights a rare presentation of Lyme disease affecting cerebral vasculature.
Observation:
- A 64-year-old man presented with hemiparesis, cognitive decline, and cerebellar syndrome.
- Cerebral imaging revealed multiple infarcts and intracranial stenosis.
- Cerebrospinal fluid analysis confirmed meningitis and positive Lyme serology with intrathecal antibody production.
Findings:
- The patient was diagnosed with Lyme meningovascularitis causing multiple ischemic strokes.
- Cerebrospinal fluid revealed meningitis and specific anti-Borrelia antibodies, indicating neuroborreliosis.
- Magnetic resonance angiography demonstrated multiple intracranial stenoses.
Implications:
- Lyme neuroborreliosis should be considered in the differential diagnosis of ischemic stroke, particularly in Lyme-endemic regions.
- Prompt diagnosis and appropriate antibiotic therapy can lead to improved clinical and radiological outcomes.
- This case underscores the importance of considering infectious causes in young or otherwise healthy stroke patients.
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