[Oculomotor paralysis and Lyme disease]

Area of Science:

• Infectious Diseases
• Neurology
• Ophthalmology

Background:

• Lyme disease, caused by Borrelia burgdorferi, is a multisystemic infection.
• Neurologic manifestations are common in the second stage, often presenting with variable symptoms.
• Ocular motor involvement can occur but is typically associated with other systemic signs.

Observation:

• A case of Lyme disease presenting exclusively with diplopia is reported.
• The patient exhibited no other systemic symptoms, differentiating it from typical presentations.
• Diagnosis was confirmed via serodiagnosis, western blot, and cerebrospinal fluid (CSF) antibody analysis.

Findings:

• Antibiotic therapy was initiated for the patient.
• Diplopia resolved rapidly within three days of starting treatment.
• The swift functional recovery underscores the effectiveness of antibiotic intervention.

Implications:

• This case suggests that isolated ocular motor nerve palsy can be a sole manifestation of Lyme disease.
• Early diagnosis and prompt antibiotic treatment are crucial for rapid recovery from neurological Lyme disease.
• The findings support the efficacy of antibiotic therapy in managing neurological complications of Lyme disease, even in atypical presentations.