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Published on: February 4, 2018
Subacute transverse myelitis with Lyme profile dissociation
M Sami Walid1, Mohammed Ajjan, Arthur J Ulm
1Medical Center of Central Georgia, Macon, GA, USA. mswalid@yahoo.com
German Medical Science : GMS E-Journal
|August 14, 2009
Summary
Subacute transverse myelitis can be associated with Lyme disease, presenting with spinal cord swelling. Early antibiotic treatment, like IV Ceftriaxone, led to rapid improvement in this case.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Transverse myelitis is a rare neurological disorder affecting 1-5 individuals per million annually.
- This case highlights subacute transverse myelitis with specific MRI and CSF findings.
Purpose of the Study:
- To present an unusual case of subacute transverse myelitis.
- To detail the diagnostic findings, including MRI and CSF analysis.
- To discuss the association with Lyme disease and treatment outcomes.
Main Methods:
- A case study of a 46-year-old woman with progressive lower extremity sensory loss.
- Diagnostic workup included blood serology for Lyme disease, MRI of the cervical spine, and cerebrospinal fluid analysis.
- Treatment involved intravenous Ceftriaxone followed by oral doxycycline.
Main Results:
- Positive Lyme disease antibodies (IgG and IgM) in blood, but negative in CSF.
- Cervical spine MRI revealed swelling and contrast enhancement in the lower cord.
- Patient showed rapid improvement after antibiotic therapy.
Conclusions:
- Transverse myelitis should be considered in myelopathy cases with spinal cord enhancement, especially with preceding flu-like symptoms.
- Lyme disease testing is crucial for neurological symptoms, acknowledging potential discrepancies in blood vs. CSF antibody titers.
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